| Halifax Regional Hospital, Inc | |
|
115 College St Clarksville VA 23927-9125 | |
| (434) 374-5344 | |
| Not Available |
| Full Name | Halifax Regional Hospital, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 115 College St, Clarksville, Virginia |
| Authorized Official Name and Position | Robert A Broermann (CFO) |
| Authorized Official Contact | 7574557020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Halifax Regional Hospital, Inc 2204 Wilborn Ave South Boston VA 24592-1645 Ph: (757) 455-7395 | Halifax Regional Hospital, Inc 115 College St Clarksville VA 23927-9125 Ph: (434) 374-5344 |
| NPI Number | 1154930824 |
|---|---|
| Provider Enumeration Date | 07/28/2020 |
| Last Update Date | 07/28/2020 |
| Medicare PECOS PAC ID | 4587572805 |
|---|---|
| Medicare Enrollment ID | O20201112001067 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154930824 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Clarksville Primary Care Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 61 Burlington Dr, Clarksville, VA 23927 Phone: 434-774-2400 |