| Norfolk Community Health Center Inc | |
|
1401 Tidewater Drive Ste 1 Norfolk VA 23504 | |
| (757) 623-0095 | |
| (757) 623-1203 |
| Full Name | Norfolk Community Health Center Inc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1401 Tidewater Drive, Norfolk, Virginia |
| Authorized Official Name and Position | Phillip Daniel Brooks (PRESIDENT) |
| Authorized Official Contact | 7576230095 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Norfolk Community Health Center Inc 1401 Tidewater Drive Ste 1 Norfolk VA 23504 Ph: (757) 623-0095 | Norfolk Community Health Center Inc 1401 Tidewater Drive Ste 1 Norfolk VA 23504 Ph: (757) 623-0095 |
| NPI Number | 1659441814 |
|---|---|
| Provider Enumeration Date | 11/08/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 2567408263 |
|---|---|
| Medicare Enrollment ID | O20050705000312 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659441814 | NPI | - | NPPES |
| 5902199 | Medicaid | NC | |
| 176497 | Other | VA | ANTHEM |
| 131851 | Other | VA | OPTIMA |
| Provider Name | Vernis L Beverly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508821174 PECOS PAC ID: 0143205161 Enrollment ID: I20040623000018 |
| Provider Name | Dianna B White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669526109 PECOS PAC ID: 3375648181 Enrollment ID: I20070423000362 |
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