Pound Medical Clinic | |
11313 Highland Ave Pound VA 24279-4145 | |
(276) 796-8100 | |
Not Available |
Full Name | Pound Medical Clinic |
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Speciality | Clinic/Center |
Location | 11313 Highland Ave, Pound, Virginia |
Authorized Official Name and Position | Delena P Miller (CREDENTIALING) |
Authorized Official Contact | 6066334823 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Pound Medical Clinic Po Box 40 Whitesburg KY 41858-0040 Ph: (606) 633-4823 | Pound Medical Clinic 11313 Highland Ave Pound VA 24279-4145 Ph: (276) 796-8100 |
NPI Number | 1366201246 |
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Provider Enumeration Date | 03/14/2024 |
Last Update Date | 04/15/2024 |
Medicare PECOS PAC ID | 7618875873 |
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Medicare Enrollment ID | O20240517000820 |
Identifier | Type | State | Issuer |
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1366201246 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
Provider Name | Kyla Stanley |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396218988 PECOS PAC ID: 8628317674 Enrollment ID: I20240517000865 |
Experienced Care Clinic Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8008 Main St, Pound, VA 24279 Phone: 276-796-4586 |