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700 Dinwiddie Ave Richmond VA 23224-5522 | |
(804) 230-1217 | |
(804) 783-2514 |
Full Name | |
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Speciality | Clinic/Center |
Location | 700 Dinwiddie Ave, Richmond, Virginia |
Authorized Official Name and Position | Beth Merchent (CEO) |
Authorized Official Contact | 8047832505 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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517 W Grace St Richmond VA 23220-4911 Ph: (804) 783-2505 | 700 Dinwiddie Ave Richmond VA 23224-5522 Ph: (804) 230-1217 |
NPI Number | 1659669596 |
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Provider Enumeration Date | 07/13/2011 |
Last Update Date | 07/14/2021 |
Medicare PECOS PAC ID | 9931010857 |
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Medicare Enrollment ID | O20111213000662 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659669596 | NPI | - | NPPES |
1659669596 | Medicaid | VA |
Taxonomy | Type | License (State) | Status |
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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 | |