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General NPI Number Information
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NPI Number | 1063540888
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Entity Type | Organization
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Legal Business Name | FAMILYCARE IN THE PLAINS, INC
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 02/04/2008
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Provider Practice Location Address
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Address Line | 4305 FAUQUIER AVE
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City | THE PLAINS
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State | VA
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Zip | 20198-0424
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Country | US
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Telephone | 540-253-5776
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Fax | 540-253-5797
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Provider Business Mailing Address
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Address Line | 4305 FAUQUIER AVE
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City | THE PLAINS
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State | VA
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Zip | 20198-0424
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Country | US
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Telephone | 540-253-5776
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Fax | 540-253-5797
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | TOMMI HURST EDWARDS
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Credential |
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Telephone | 540-253-5776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101023772
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License Number State | VA
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