| Health Centers Of The Piedmont South Boston | |
|
2524 Houghton Ave South Boston VA 24592 | |
| (434) 575-1336 | |
| (434) 575-1349 |
| Full Name | Health Centers Of The Piedmont South Boston |
|---|---|
| Speciality | Clinic/Center |
| Location | 2524 Houghton Ave, South Boston, Virginia |
| Authorized Official Name and Position | Marsha Mendenhall (CEO) |
| Authorized Official Contact | 4347913630 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Health Centers Of The Piedmont South Boston 705 Main St Danville VA 24541-1803 Ph: (434) 791-4122 | Health Centers Of The Piedmont South Boston 2524 Houghton Ave South Boston VA 24592 Ph: (434) 575-1336 |
| NPI Number | 1235677634 |
|---|---|
| Provider Enumeration Date | 02/06/2017 |
| Last Update Date | 03/05/2024 |
| Medicare PECOS PAC ID | 3476512427 |
|---|---|
| Medicare Enrollment ID | O20170518002848 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235677634 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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