| |
300 Medical Dr Hampton VA 23666-1765 | |
(757) 788-0400 | |
(757) 788-0969 |
Full Name | |
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Speciality | Clinic/Center |
Location | 300 Medical Dr, Hampton, Virginia |
Authorized Official Name and Position | Angela Futrell (CEO) |
Authorized Official Contact | 7575910643 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1033 28th St 2nd Floor Newport News VA 23607-4233 Ph: (757) 591-0643 | 300 Medical Dr Hampton VA 23666-1765 Ph: (757) 788-0400 |
NPI Number | 1528446507 |
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Provider Enumeration Date | 05/11/2015 |
Last Update Date | 12/28/2023 |
Medicare PECOS PAC ID | 9234040148 |
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Medicare Enrollment ID | O20150812007902 |
Identifier | Type | State | Issuer |
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1528446507 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Mbs Child Wellness Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 240 S Second St, Hampton, VA 23664 Phone: 767-902-6108 | |
Gastroenterology Specialist Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 Marcella Rd, Suite A, Hampton, VA 23666 Phone: 757-826-6539 | |
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