| Geriatric Care Associates Of Roanoke | |
|
391 Hershberger Rd Roanoke VA 24012-1983 | |
| (540) 384-5977 | |
| Not Available |
| Full Name | Geriatric Care Associates Of Roanoke |
|---|---|
| Speciality | Clinic/Center |
| Location | 391 Hershberger Rd, Roanoke, Virginia |
| Authorized Official Name and Position | Joseph M Hoff (PESIDENT/CEO) |
| Authorized Official Contact | 5402652087 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Geriatric Care Associates Of Roanoke 391 Hershberger Rd Roanoke VA 24012-1983 Ph: (540) 265-2087 | Geriatric Care Associates Of Roanoke 391 Hershberger Rd Roanoke VA 24012-1983 Ph: (540) 384-5977 |
| NPI Number | 1366041170 |
|---|---|
| Provider Enumeration Date | 10/22/2020 |
| Last Update Date | 01/26/2023 |
| Medicare PECOS PAC ID | 2567874571 |
|---|---|
| Medicare Enrollment ID | O20201216001752 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366041170 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Mazen I Madhoun |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518127927 PECOS PAC ID: 5395930754 Enrollment ID: I20101110001315 |
| Provider Name | Benita D Bocanegra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962029827 PECOS PAC ID: 6406259613 Enrollment ID: I20210726003060 |
| Provider Name | Pamela Renee Richardson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750080974 PECOS PAC ID: 7214396035 Enrollment ID: I20230711002056 |
| Provider Name | Marta Pacheco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053076554 PECOS PAC ID: 8123401866 Enrollment ID: I20240424002337 |
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