| Family Immediate Care,llc | |
|
420 Elden St Herndon VA 20170-4511 | |
| (571) 218-5788 | |
| Not Available |
| Full Name | Family Immediate Care,llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 420 Elden St, Herndon, Virginia |
| Authorized Official Name and Position | Phetpailin Amaralikit (PRESIDENT) |
| Authorized Official Contact | 5712185788 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Immediate Care,llc 9429 Winterset Dr Potomac MD 20854-2845 Ph: (571) 218-5788 | Family Immediate Care,llc 420 Elden St Herndon VA 20170-4511 Ph: (571) 218-5788 |
| NPI Number | 1962893974 |
|---|---|
| Provider Enumeration Date | 02/12/2015 |
| Last Update Date | 02/12/2015 |
| Medicare PECOS PAC ID | 0042539835 |
|---|---|
| Medicare Enrollment ID | O20150429000252 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962893974 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0101244099 (Virginia) | Primary |
| Provider Name | Phetpailin Amaralikit |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730356619 PECOS PAC ID: 1456537984 Enrollment ID: I20110518000688 |
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