South River Medical Clinic, Llc | |
100 7th Street Grottoes VA 24441 | |
(540) 249-5901 | |
(540) 249-5902 |
Full Name | South River Medical Clinic, Llc |
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Speciality | Clinic/Center |
Location | 100 7th Street, Grottoes, Virginia |
Authorized Official Name and Position | Anna Williams (OFFICE MANAGER) |
Authorized Official Contact | 5402495901 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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South River Medical Clinic, Llc Po Box 489 Grottoes VA 24441-0489 Ph: () - | South River Medical Clinic, Llc 100 7th Street Grottoes VA 24441 Ph: (540) 249-5901 |
NPI Number | 1922381789 |
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Provider Enumeration Date | 09/27/2011 |
Last Update Date | 08/03/2012 |
Medicare PECOS PAC ID | 9830365949 |
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Medicare Enrollment ID | O20111220000441 |
Identifier | Type | State | Issuer |
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1922381789 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Sharon L Strang |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528037678 PECOS PAC ID: 4688634207 Enrollment ID: I20041018000459 |
Provider Name | Sheri A Tratnack |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164401295 PECOS PAC ID: 9931100286 Enrollment ID: I20070129000739 |
Provider Name | Mary C Koogler |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1912908468 PECOS PAC ID: 0749456853 Enrollment ID: I20120215000159 |
Provider Name | Tracy D Seefried |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306499207 PECOS PAC ID: 8820418601 Enrollment ID: I20201015003177 |