| Farmville Internal Medicine, Pc | |
|
1400 Milnwood Rd Farmville VA 23901-2633 | |
| (434) 392-9000 | |
| (434) 392-9215 |
| Full Name | Farmville Internal Medicine, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1400 Milnwood Rd, Farmville, Virginia |
| Authorized Official Name and Position | Vara P Bonagiri (PRESIDENT) |
| Authorized Official Contact | 4343929000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Farmville Internal Medicine, Pc Po Box R Farmville VA 23901-0289 Ph: (434) 392-9000 | Farmville Internal Medicine, Pc 1400 Milnwood Rd Farmville VA 23901-2633 Ph: (434) 392-9000 |
| NPI Number | 1063717304 |
|---|---|
| Provider Enumeration Date | 01/18/2011 |
| Last Update Date | 03/02/2012 |
| Medicare PECOS PAC ID | 9032394317 |
|---|---|
| Medicare Enrollment ID | O20110502000253 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063717304 | NPI | - | NPPES |
| 5865514 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0101054184 (Virginia) | Primary |
| Provider Name | Vara P Bonagiri |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1801810486 PECOS PAC ID: 7012192396 Enrollment ID: I20110502000296 |
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