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1500 N Lombardy St Richmond VA 23220-1711 | |
(804) 780-0840 | |
(804) 780-0862 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1500 N Lombardy St, Richmond, Virginia |
Authorized Official Name and Position | Tracy Causey (CEO) |
Authorized Official Contact | 8042531968 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2809 North Ave Richmond VA 23222-3647 Ph: (804) 780-0840 | 1500 N Lombardy St Richmond VA 23220-1711 Ph: (804) 780-0840 |
NPI Number | 1366920530 |
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Provider Enumeration Date | 07/31/2018 |
Last Update Date | 11/17/2022 |
Medicare PECOS PAC ID | 9638064850 |
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Medicare Enrollment ID | O20181130001418 |
Identifier | Type | State | Issuer |
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1366920530 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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 | |