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410 Industrial Drive Louisa VA 23093 | |
| (434) 581-3271 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 410 Industrial Drive, Louisa, Virginia |
| Authorized Official Name and Position | Charles Allbaugh (CFO) |
| Authorized Official Contact | 4345814073 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 220 New Canton VA 23123-0220 Ph: (434) 581-4073 | 410 Industrial Drive Louisa VA 23093 Ph: (434) 581-3271 |
| NPI Number | 1104014703 |
|---|---|
| Provider Enumeration Date | 10/09/2007 |
| Last Update Date | 03/07/2024 |
| Medicare PECOS PAC ID | 0345158432 |
|---|---|
| Medicare Enrollment ID | O20080115000229 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104014703 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Louisa Family Practice, Plc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 101 Woolfolk Avenue, Louisa, VA 23093 Phone: 540-967-2202 Fax: 540-967-1676 |