| Kempsville Primary Medical Care Center Inc | |
|
5136 Princess Anne Rd Virginia Bch VA 23462-4228 | |
| (757) 473-0003 | |
| (757) 497-9510 |
| Full Name | Kempsville Primary Medical Care Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5136 Princess Anne Rd, Virginia Bch, Virginia |
| Authorized Official Name and Position | Josue Apilan Miranda (OWNER) |
| Authorized Official Contact | 7574730003 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kempsville Primary Medical Care Center Inc 5136 Princess Anne Rd Virginia Bch VA 23462-4228 Ph: (757) 473-0003 | Kempsville Primary Medical Care Center Inc 5136 Princess Anne Rd Virginia Bch VA 23462-4228 Ph: (757) 473-0003 |
| NPI Number | 1013187947 |
|---|---|
| Provider Enumeration Date | 03/06/2008 |
| Last Update Date | 03/07/2008 |
| Medicare PECOS PAC ID | 2062604135 |
|---|---|
| Medicare Enrollment ID | O20101007000497 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013187947 | NPI | - | NPPES |
| 7320256 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 0101034998 (Virginia) | Primary |
| Provider Name | Josue A Miranda |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1821038555 PECOS PAC ID: 2961694039 Enrollment ID: I20101007000519 |
Legacy Care Aco Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2901 S Lynnhaven Rd Ste 450, Virginia Bch, VA 23452 Phone: 757-536-2411 | |
Doppler Alliance Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4772 Euclid Rd Ste D, Virginia Bch, VA 23462 Phone: 757-685-7232 |