Organization Name: | FAMILY CARE OF BLACKSBURG |
NPI Number: | 1134343551 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ELLEN RABUN (DOCTOR) |
Mailing Address: | 708 N Main St Ste 200 Blacksburg |
State: | VA US |
Postal Code: | 240603634 |
Phone Number: | 5409519444 |
Fax Number: | 5409513270 |
NPI Enumeration Date: | 04/13/2007 |
NPI Last Update Date: | 04/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | ========= |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |