| Konnarock Family Health Center | |
|
20471 Azen Rd Damascus VA 24236-4141 | |
| (276) 388-3411 | |
| (276) 388-3732 |
| Full Name | Konnarock Family Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 20471 Azen Rd, Damascus, Virginia |
| Authorized Official Name and Position | Malcom Perdue (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2765465310 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Konnarock Family Health Center 20471 Azen Rd Damascus VA 24236-4141 Ph: (276) 388-3411 | Konnarock Family Health Center 20471 Azen Rd Damascus VA 24236-4141 Ph: (276) 388-3411 |
| NPI Number | 1225150824 |
|---|---|
| Provider Enumeration Date | 04/04/2007 |
| Last Update Date | 07/21/2021 |
| Medicare PECOS PAC ID | 0244124584 |
|---|---|
| Medicare Enrollment ID | O20070612000300 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225150824 | NPI | - | NPPES |
| 007604092 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Holston Family Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 306 South Shady Avenue, Damascus, VA 24236 Phone: 276-475-5116 Fax: 276-475-5665 |