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2199 Old Bridge Rd Lake Ridge VA 22192-2911 | |
(703) 357-9707 | |
(703) 357-9708 |
Full Name | |
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Speciality | Clinic/Center |
Location | 2199 Old Bridge Rd, Lake Ridge, Virginia |
Authorized Official Name and Position | George H. Morison (PRESIDENT) |
Authorized Official Contact | 8049685700 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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5000 Cox Rd Glen Allen VA 23060-9263 Ph: (804) 968-5700 | 2199 Old Bridge Rd Lake Ridge VA 22192-2911 Ph: (703) 357-9707 |
NPI Number | 1902147374 |
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Provider Enumeration Date | 03/11/2013 |
Last Update Date | 01/27/2021 |
Medicare PECOS PAC ID | 0143132688 |
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Medicare Enrollment ID | O20130919000163 |
Identifier | Type | State | Issuer |
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1902147374 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Primary |
Amy L Friedenthal Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12512 Lake Ridge Dr Ste D, Lake Ridge, VA 22192 Phone: 703-497-5555 Fax: 703-497-1479 | |
Primary Gerontology Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4196 Merchant Plz Ste 348, Lake Ridge, VA 22192 Phone: 571-206-1650 | |