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2195 Euclid Avenue Suite 6 Bristol VA 24201-3655 | |
(276) 669-5179 | |
(276) 466-8870 |
Full Name | |
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Speciality | Clinic/Center |
Location | 2195 Euclid Avenue, Bristol, Virginia |
Authorized Official Name and Position | Joseph Bryan Haynes (CEO) |
Authorized Official Contact | 2764964492 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 729 Saltville VA 24370-0729 Ph: (276) 496-4492 | 2195 Euclid Avenue Suite 6 Bristol VA 24201-3655 Ph: (276) 669-5179 |
NPI Number | 1225169295 |
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Provider Enumeration Date | 03/08/2007 |
Last Update Date | 06/07/2021 |
Medicare PECOS PAC ID | 4880502707 |
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Medicare Enrollment ID | O20100625000377 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225169295 | NPI | - | NPPES |
010062411 | Medicaid | VA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Finch Family Medical Care. Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1318 Euclid Ave, Suite 2-3, Bristol, VA 24201 Phone: 276-466-0744 Fax: 276-466-1628 | |
Southwest Virginia Community Health Systems Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 650 Long Crescent Dr, Bristol, VA 24201 Phone: 276-496-4492 | |