Full Name | |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 305 N Main St, Gretna, Virginia |
Authorized Official Name and Position | Charlotte Lawrence (SECRETARY) |
Authorized Official Contact | 6159207000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
305 N Main St Gretna VA 24557-4176 Ph: (434) 656-2224 | 305 N Main St Gretna VA 24557-4176 Ph: (434) 656-2224 |
NPI Number | 1508077603 |
---|---|
Provider Enumeration Date | 05/24/2007 |
Last Update Date | 09/24/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508077603 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 49-3836 (Virginia) | Primary |