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General NPI Number Information
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NPI Number | 1114930732
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Entity Type | Organization
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Legal Business Name | WASHINGTON SQUARE RHC
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 06/10/2008
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Provider Practice Location Address
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Address Line | 3150 CLINCH ST
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City | RICHLANDS
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State | VA
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Zip | 24641-2172
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Country | US
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Telephone | 276-964-6711
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Fax | 276-964-2240
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Provider Business Mailing Address
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Address Line | 3150 CLINCH ST P.O. BOX 645
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City | RICHLANDS
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State | VA
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Zip | 24641-2172
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Country | US
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Telephone | 276-964-6711
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Fax | 276-964-2240
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Authorized Official
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Title or Position | PRESIDENT
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Name | TUSHAR G PATEL
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Credential | M.D.
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Telephone | 276-963-2231
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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