Healthcare Provider Details

I. General information

NPI: 1689301590
Provider Name (Legal Business Name): ANCHOR HEALTHCARE, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2022
Last Update Date: 08/02/2022
Certification Date: 07/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1490 PANTOPS MOUNTAIN PL
CHARLOTTESVILLE VA
22911-4601
US

IV. Provider business mailing address

PO BOX 7445
CHARLOTTESVILLE VA
22906-7445
US

V. Phone/Fax

Practice location:
  • Phone: 434-979-4440
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: AMANDA BURNS
Title or Position: ADMINISTRATOR
Credential:
Phone: 434-227-7588