| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 8575 Ivor Road, Ivor, Virginia |
| Authorized Official Name and Position | Cheryl Ebersole (ADMINISTRATOR) |
| Authorized Official Contact | 7578596161 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
8575 Ivor Road Ivor VA 23866 Ph: (757) 859-6161 | 8575 Ivor Road Ivor VA 23866 Ph: (757) 859-6161 |
| NPI Number | 1437378031 |
|---|---|
| Provider Enumeration Date | 04/24/2007 |
| Last Update Date | 08/24/2007 |
| Medicare PECOS PAC ID | 1153232749 |
|---|---|
| Medicare Enrollment ID | O20030808000014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437378031 | NPI | - | NPPES |
| 007695594 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Horizon Health Services, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8575 Ivor Rd, Ivor, VA 23866 Phone: 757-859-6161 Fax: 757-859-6452 |