| Virginia Healthcare, Pc | |
|
16313 Falconers Ter Moseley VA 23120-1655 | |
| (804) 554-6134 | |
| (804) 681-7102 |
| Full Name | Virginia Healthcare, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 16313 Falconers Ter, Moseley, Virginia |
| Authorized Official Name and Position | Altory Musni Miranda (OWNER) |
| Authorized Official Contact | 8045546134 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Virginia Healthcare, Pc Po Box 17830 Richmond VA 23226-7830 Ph: (804) 554-6134 | Virginia Healthcare, Pc 16313 Falconers Ter Moseley VA 23120-1655 Ph: (804) 554-6134 |
| NPI Number | 1700445673 |
|---|---|
| Provider Enumeration Date | 06/13/2019 |
| Last Update Date | 06/13/2019 |
| Medicare PECOS PAC ID | 6002099546 |
|---|---|
| Medicare Enrollment ID | O20110322000337 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700445673 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Secondary |
| Provider Name | Altory M Miranda |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871891507 PECOS PAC ID: 5991988438 Enrollment ID: I20110531000167 |
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