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4620 S Laburnum Ave Richmond VA 23231 | |
(804) 226-2444 | |
(804) 222-0458 |
Full Name | |
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Speciality | Family Medicine |
Location | 4620 S Laburnum Ave, Richmond, Virginia |
Authorized Official Name and Position | Cassie Lowe (DIRECTOR PAYER ENROLLMENT) |
Authorized Official Contact | 5139525210 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 639995 Cincinnati OH 45263-9995 Ph: () - | 4620 S Laburnum Ave Richmond VA 23231 Ph: (804) 226-2444 |
NPI Number | 1003849589 |
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Provider Enumeration Date | 07/08/2006 |
Last Update Date | 04/24/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003849589 | NPI | - | NPPES |
CN5711 | Other | VA | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
208000000X | Pediatrics | (* (Not Available)) | Secondary |
Mary Brantley Holmes Msn Whnp-bc Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8955 Wishart Rd, Richmond, VA 23229 Phone: 804-928-5596 | |
Independent Associates Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7605 Forest Ave, Ste 211, Richmond, VA 23229 Phone: 804-282-3114 Fax: 804-285-9723 | |