| Igata And Parke Plc | |
|
14805 Forest Rd Ste 229 Forest VA 24551-5019 | |
| (540) 986-5480 | |
| Not Available |
| Full Name | Igata And Parke Plc |
|---|---|
| Speciality | Family Medicine |
| Location | 14805 Forest Rd Ste 229, Forest, Virginia |
| Authorized Official Name and Position | Raven Parke (CO-FOUNDER) |
| Authorized Official Contact | 5409865480 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Igata And Parke Plc 14805 Forest Rd Ste 229 Forest VA 24551-5019 Ph: () - | Igata And Parke Plc 14805 Forest Rd Ste 229 Forest VA 24551-5019 Ph: (540) 986-5480 |
| NPI Number | 1619730835 |
|---|---|
| Provider Enumeration Date | 01/31/2024 |
| Last Update Date | 04/18/2024 |
| Medicare PECOS PAC ID | 9234671744 |
|---|---|
| Medicare Enrollment ID | O20240611003308 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619730835 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Amanda J Igata |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063844926 PECOS PAC ID: 5193959872 Enrollment ID: I20131011001173 |
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