| Prime Care Health Services Pc | |
|
1714 E Hundred Rd Suite 101 Chester VA 23831 | |
| (804) 530-5293 | |
| (804) 530-5295 |
| Full Name | Prime Care Health Services Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1714 E Hundred Rd, Chester, Virginia |
| Authorized Official Name and Position | Gohar M Abbasi (PRESIDENT) |
| Authorized Official Contact | 8045305293 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Care Health Services Pc Po Box 11768 Richmond VA 23230-0168 Ph: (804) 353-4000 | Prime Care Health Services Pc 1714 E Hundred Rd Suite 101 Chester VA 23831 Ph: (804) 530-5293 |
| NPI Number | 1831158401 |
|---|---|
| Provider Enumeration Date | 03/21/2006 |
| Last Update Date | 08/09/2019 |
| Medicare PECOS PAC ID | 0042382640 |
|---|---|
| Medicare Enrollment ID | O20080626000162 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831158401 | NPI | - | NPPES |
| 005830915 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Gohar M Abbasi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134198187 PECOS PAC ID: 0941372544 Enrollment ID: I20080626000207 |
| Provider Name | Tahir H Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942250378 PECOS PAC ID: 7517980345 Enrollment ID: I20080911000335 |
| Provider Name | Lisa Danielle Welcher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275036667 PECOS PAC ID: 3678828654 Enrollment ID: I20180614002244 |
| Provider Name | Lilian Ogochukwu Okafor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235816760 PECOS PAC ID: 9638532732 Enrollment ID: I20230822002964 |
| Provider Name | Courtney R Wyatt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568246395 PECOS PAC ID: 9537514112 Enrollment ID: I20231017003204 |
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