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213 Monarch Road St Charles VA 24282 | |
(276) 383-4428 | |
(276) 383-4910 |
Full Name | |
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Speciality | Clinic/Center |
Location | 213 Monarch Road, St Charles, Virginia |
Authorized Official Name and Position | Malcolm Perdue (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 2765465310 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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276 Fieldstone Dr Jonesville VA 24263-1215 Ph: (276) 546-5310 | 213 Monarch Road St Charles VA 24282 Ph: (276) 383-4428 |
NPI Number | 1215284153 |
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Provider Enumeration Date | 08/09/2012 |
Last Update Date | 07/21/2021 |
Medicare PECOS PAC ID | 0244124584 |
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Medicare Enrollment ID | O20090603000224 |
Identifier | Type | State | Issuer |
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1215284153 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |