| |
107 S 5th St Richmond VA 23219-3825 | |
(804) 719-4000 | |
(804) 783-2514 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 107 S 5th St, Richmond, Virginia |
Authorized Official Name and Position | Peter Prizio (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 8047832505 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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517 W Grace St Richmond VA 23220-4911 Ph: (804) 783-2505 | 107 S 5th St Richmond VA 23219-3825 Ph: (804) 719-4000 |
NPI Number | 1982992608 |
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Provider Enumeration Date | 07/15/2011 |
Last Update Date | 12/04/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1982992608 | NPI | - | NPPES |
1982992608 | Medicaid | VA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Mary Brantley Holmes Msn Whnp-bc Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8955 Wishart Rd, Richmond, VA 23229 Phone: 804-928-5596 | |
Independent Associates Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7605 Forest Ave, Ste 211, Richmond, VA 23229 Phone: 804-282-3114 Fax: 804-285-9723 | |