| |
1020 Terrace Dr Suite 100 Marion VA 24354 | |
(276) 783-5157 | |
(276) 783-5159 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1020 Terrace Dr, Marion, Virginia |
Authorized Official Name and Position | Tina B Blevins (ADMINISTRATOR) |
Authorized Official Contact | 2767835157 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1020 Terrace Dr Suite 100 Marion VA 24354-4392 Ph: (276) 783-5157 | 1020 Terrace Dr Suite 100 Marion VA 24354 Ph: (276) 783-5157 |
NPI Number | 1427155472 |
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Provider Enumeration Date | 09/20/2006 |
Last Update Date | 02/20/2020 |
Medicare PECOS PAC ID | 6406837145 |
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Medicare Enrollment ID | O20040527000853 |
Identifier | Type | State | Issuer |
---|---|---|---|
1427155472 | NPI | - | NPPES |
9234080 | Medicaid | VA | |
009234080 | Medicaid | VA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 0618000072 (Virginia) | Primary |
Provider Name | Amy R Blue |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1639307010 PECOS PAC ID: 6002962693 Enrollment ID: I20090923000527 |
Provider Name | Anita Susan Keene |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1013014067 PECOS PAC ID: 2567443203 Enrollment ID: I20120112000366 |
Southwest Virginia Community Health Systems Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 416 E Main St Rm 2, Marion, VA 24354 Phone: 276-783-8185 | |
The Garzon Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1122 Culbert Drive, Marion, VA 24354 Phone: 276-783-7913 Fax: 276-783-1882 | |
Dave Parker Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1224 Greer Ave, Marion, VA 24354 Phone: 276-920-7242 | |