| Caritas | |
|
2220 Stockton St Richmond VA 23224-3707 | |
| (804) 887-1574 | |
| (804) 354-8220 |
| Full Name | Caritas |
|---|---|
| Speciality | Clinic/Center |
| Location | 2220 Stockton St, Richmond, Virginia |
| Authorized Official Name and Position | Tonya Lynn Kimbrough (ADMINISTRATIVE AFFAIRS COORDINATOR) |
| Authorized Official Contact | 8047832505 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Caritas 517 W Grace St Richmond VA 23220-4911 Ph: (804) 783-2505 | Caritas 2220 Stockton St Richmond VA 23224-3707 Ph: (804) 887-1574 |
| NPI Number | 1649825092 |
|---|---|
| Provider Enumeration Date | 08/02/2019 |
| Last Update Date | 02/16/2021 |
| Medicare PECOS PAC ID | 9931010857 |
|---|---|
| Medicare Enrollment ID | O20191119002360 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649825092 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Mark E Stevens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114385242 PECOS PAC ID: 0941261812 Enrollment ID: I20041023000249 |
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