| Minority Aids Support Services Inc | |
|
247 28th St Ste 100 Newport News VA 23607-3907 | |
| (757) 586-5243 | |
| Not Available |
| Full Name | Minority Aids Support Services Inc |
|---|---|
| Speciality | General Practice |
| Location | 247 28th St Ste 100, Newport News, Virginia |
| Authorized Official Name and Position | Gwendolyn Ellis-wilson (MANAGER/AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 7575865243 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Minority Aids Support Services Inc 2715 Huntington Ave Newport News VA 23607-3913 Ph: (757) 240-4363 | Minority Aids Support Services Inc 247 28th St Ste 100 Newport News VA 23607-3907 Ph: (757) 586-5243 |
| NPI Number | 1619660883 |
|---|---|
| Provider Enumeration Date | 06/01/2023 |
| Last Update Date | 12/21/2023 |
| Medicare PECOS PAC ID | 1850747684 |
|---|---|
| Medicare Enrollment ID | O20231030003087 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619660883 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Alex P Taylor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881654192 PECOS PAC ID: 2062495187 Enrollment ID: I20050705000338 |
| Provider Name | Arnice Jackson Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912698911 PECOS PAC ID: 8022464858 Enrollment ID: I20231030003378 |
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