| Holston Family Health Center | |
|
306 South Shady Avenue Damascus VA 24236 | |
| (276) 475-5116 | |
| (276) 475-5665 |
| Full Name | Holston Family Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 306 South Shady Avenue, Damascus, Virginia |
| Authorized Official Name and Position | Malcom Perdue (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2764755116 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Holston Family Health Center 306 South Shady Avenue Damascus VA 24236 Ph: (276) 475-5116 | Holston Family Health Center 306 South Shady Avenue Damascus VA 24236 Ph: (276) 475-5116 |
| NPI Number | 1679695316 |
|---|---|
| Provider Enumeration Date | 04/04/2007 |
| Last Update Date | 06/23/2011 |
| Medicare PECOS PAC ID | 0244124584 |
|---|---|
| Medicare Enrollment ID | O20070612000363 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679695316 | NPI | - | NPPES |
| 007603002 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Konnarock Family Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 20471 Azen Rd, Damascus, VA 24236 Phone: 276-388-3411 Fax: 276-388-3732 |