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2405 Atherholt Rd Lynchburg VA 24501-2184 | |
(434) 485-8500 | |
(434) 485-8599 |
Full Name | |
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Speciality | Clinic/Center |
Location | 2405 Atherholt Rd, Lynchburg, Virginia |
Authorized Official Name and Position | Nicole Proffitt (CREDENTIALING & ENROLLMENT) |
Authorized Official Contact | 8045332357 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 715868 Philadelphia PA 19171-5868 Ph: (804) 915-1910 | 2405 Atherholt Rd Lynchburg VA 24501-2184 Ph: (434) 485-8500 |
NPI Number | 1174558472 |
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Provider Enumeration Date | 07/12/2006 |
Last Update Date | 06/02/2022 |
Medicare PECOS PAC ID | 0547157224 |
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Medicare Enrollment ID | O20160302002105 |
Identifier | Type | State | Issuer |
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1174558472 | NPI | - | NPPES |
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