| Longevity Clinical Ltc Associates Of Virginia, Pllc | |
|
906 Thompson St Ashland VA 23005-1128 | |
| (804) 798-3291 | |
| Not Available |
| Full Name | Longevity Clinical Ltc Associates Of Virginia, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 906 Thompson St, Ashland, Virginia |
| Authorized Official Name and Position | Diane Vincur (LWC PRACTICE MANAGER) |
| Authorized Official Contact | 5618152427 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Longevity Clinical Ltc Associates Of Virginia, Pllc 11780 Us Highway 1 Ste N107 North Palm Beach FL 33408-3007 Ph: (561) 815-2427 | Longevity Clinical Ltc Associates Of Virginia, Pllc 906 Thompson St Ashland VA 23005-1128 Ph: (804) 798-3291 |
| NPI Number | 1164105607 |
|---|---|
| Provider Enumeration Date | 08/10/2023 |
| Last Update Date | 08/10/2023 |
| Medicare PECOS PAC ID | 2567801673 |
|---|---|
| Medicare Enrollment ID | O20240422001431 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164105607 | NPI | - | NPPES |
| Provider Name | Monicah Ndungu Canty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679163018 PECOS PAC ID: 4587078886 Enrollment ID: I20210127003595 |
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