Organization Name: | FAMILY HEALTH CARE ASSOCIATES OF SWVA.,PC |
NPI Number: | 1003955337 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DEBORAH A BAILEY (CHIEF EXECUTIVE OFFICER) |
Mailing Address: | 143 W Main St Lebanon |
State: | VA US |
Postal Code: | 242664430 |
Phone Number: | 2768892394 |
Fax Number: | 2768894716 |
NPI Enumeration Date: | 02/05/2007 |
NPI Last Update Date: | 01/06/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |