| Mendota Medical Center | |
|
2534 Mendota Rd Mendota VA 24270-2018 | |
| (276) 645-6710 | |
| (276) 645-6712 |
| Full Name | Mendota Medical Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 2534 Mendota Rd, Mendota, Virginia |
| Authorized Official Name and Position | Cindy M Locke (BILLING ADMINISTRATOR) |
| Authorized Official Contact | 4232243250 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mendota Medical Center 999 Executive Park Blvd Suite 201 Kingsport TN 37660-4632 Ph: (423) 224-3250 | Mendota Medical Center 2534 Mendota Rd Mendota VA 24270-2018 Ph: (276) 645-6710 |
| NPI Number | 1497874150 |
|---|---|
| Provider Enumeration Date | 03/27/2007 |
| Last Update Date | 04/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497874150 | NPI | - | NPPES |
| CC3164 | Other | VA | RAIL ROAD MEDICARE |
| 4409966 | Medicaid | TN | |
| 1527279 | Other | VA | UMWA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Stone Mountain Health Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2534 Mendota Road, Mendota, VA 24270 Phone: 276-645-6710 |