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5249 Olde Towne Rd Williamsburg VA 23188-8111 | |
(757) 259-3258 | |
(757) 220-1953 |
Full Name | |
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Speciality | Clinic/Center |
Location | 5249 Olde Towne Rd, Williamsburg, Virginia |
Authorized Official Name and Position | Denise A Bowles (BUSINESS MANAGER) |
Authorized Official Contact | 7572593254 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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5249 Olde Towne Rd Williamsburg VA 23188-8111 Ph: (757) 259-3258 | 5249 Olde Towne Rd Williamsburg VA 23188-8111 Ph: (757) 259-3258 |
NPI Number | 1639137078 |
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Provider Enumeration Date | 05/03/2006 |
Last Update Date | 01/29/2008 |
Medicare PECOS PAC ID | 3577632645 |
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Medicare Enrollment ID | O20080515000013 |
Identifier | Type | State | Issuer |
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1639137078 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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