| Healthcare On The Square | |
|
380 Washington Street Boydton VA 23917-0540 | |
| (434) 738-6102 | |
| (434) 738-6982 |
| Full Name | Healthcare On The Square |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 380 Washington Street, Boydton, Virginia |
| Authorized Official Name and Position | Angela N Miller (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 4347386102 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthcare On The Square P.o. Box 540 Boydton VA 23917-0540 Ph: (434) 738-6102 | Healthcare On The Square 380 Washington Street Boydton VA 23917-0540 Ph: (434) 738-6102 |
| NPI Number | 1255319661 |
|---|---|
| Provider Enumeration Date | 01/05/2006 |
| Last Update Date | 07/30/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255319661 | NPI | - | NPPES |
| 007691092 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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