MEDICARE: MR. BRIAN KEITH MEEKINS

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	3747A0650X	Attendant Care Provider

General Provider Information

NPI Number	:	1720611056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRIAN KEITH MEEKINS

Provider Business Mailing Address
First Line	:	3721 COLONIAL TRL E
Second Line	:
City	:	SURRY
State	:	VA
Zip	:	23883-2311
Country	:	US
Telephone Number	:	757-525-5825
Fax Number	:	757-294-3459

Provider Business Practice Location Address
First Line	:	3721 COLONIAL TRL E
Second Line	:
City	:	SURRY
State	:	VA
Zip	:	23883-2311
Country	:	US
Telephone Number	:	757-525-5825
Fax Number	:	757-294-3459

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2020
Last Update Date	:	02/14/2020

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