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General NPI Number Information
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NPI Number | 1154567683
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Entity Type | Organization
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Legal Business Name | AUGUSTA REGIONAL FREE CLINIC, INC.
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Dates
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Enumeration Date | 01/06/2009
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Last Update Date | 01/06/2009
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Provider Practice Location Address
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Address Line | 342 MULE ACADEMY RD
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City | FISHERSVILLE
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State | VA
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Zip | 22939-2256
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Country | US
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Telephone | 540-332-5606
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Fax | 540-332-5610
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Provider Business Mailing Address
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Address Line | 342 MULE ACADEMY RD P.O. BOX 153
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City | FISHERSVILLE
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State | VA
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Zip | 22939-2256
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Country | US
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Telephone | 540-332-5606
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Fax | 540-332-5610
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. MARGARET A HERSH
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Credential |
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Telephone | 540-332-5611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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