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204 N Hamilton St Suite B Richmond VA 23221-2662 | |
(804) 353-1230 | |
(804) 353-3342 |
Full Name | |
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Speciality | Family Medicine |
Location | 204 N Hamilton St, Richmond, Virginia |
Authorized Official Name and Position | Bruce Jarvie (VP, TREASURER) |
Authorized Official Contact | 2143793300 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1720 Lakepointe Dr Ste 117 Lewisville TX 75057-6425 Ph: (214) 379-3300 | 204 N Hamilton St Suite B Richmond VA 23221-2662 Ph: (804) 353-1230 |
NPI Number | 1255604674 |
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Provider Enumeration Date | 02/15/2012 |
Last Update Date | 07/29/2024 |
Medicare PECOS PAC ID | 2769644533 |
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Medicare Enrollment ID | O20120424000747 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255604674 | NPI | - | NPPES |
1255604674 | Medicaid | VA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 0101037152 (Virginia) | Primary |
Provider Name | Annette S Graham |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033173380 PECOS PAC ID: 8628092020 Enrollment ID: I20060125000136 |
Provider Name | Erin Marie Deibel |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194238576 PECOS PAC ID: 1355600909 Enrollment ID: I20180105001407 |
Mary Brantley Holmes Msn Whnp-bc Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8955 Wishart Rd, Richmond, VA 23229 Phone: 804-928-5596 | |
Independent Associates Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7605 Forest Ave, Ste 211, Richmond, VA 23229 Phone: 804-282-3114 Fax: 804-285-9723 | |