MEDICARE: AMERICAN GREATEST CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1467323519
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN GREATEST CARE LLC

Provider Business Mailing Address
First Line	:	14087 RICHMOND HWY STE 101
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22191-2171
Country	:	US
Telephone Number	:	571-300-8000
Fax Number	:

Provider Business Practice Location Address
First Line	:	14087 RICHMOND HWY STE 101
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22191-2171
Country	:	US
Telephone Number	:	571-300-8000
Fax Number	:

Authorized Official
Title or Position	:	MD
Name	:	JOHN TIMOTHY CARMACK
Credential	:
Telephone Number	:	336-884-4050

Provider Enumeration Date	:	09/12/2025
Last Update Date	:	09/12/2025

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