Premiere Care Llc | |
501 Ves Rd Lynchburg VA 24503-4638 | |
(434) 386-3540 | |
Not Available |
Full Name | Premiere Care Llc |
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Speciality | Internal Medicine |
Location | 501 Ves Rd, Lynchburg, Virginia |
Authorized Official Name and Position | Archibald Lord (MR.) |
Authorized Official Contact | 4349425463 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Premiere Care Llc 1545 Lejack Cir Forest VA 24551-1267 Ph: (434) 942-5463 | Premiere Care Llc 501 Ves Rd Lynchburg VA 24503-4638 Ph: (434) 386-3540 |
NPI Number | 1972347086 |
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Provider Enumeration Date | 06/24/2024 |
Last Update Date | 08/15/2024 |
Medicare PECOS PAC ID | 5597204362 |
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Medicare Enrollment ID | O20240823002672 |
Identifier | Type | State | Issuer |
---|---|---|---|
1972347086 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Archibald L Lord |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1427048446 PECOS PAC ID: 3375615529 Enrollment ID: I20100505000577 |
Provider Name | Angel Yauchzee |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215602990 PECOS PAC ID: 0143613422 Enrollment ID: I20220310002751 |
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