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General NPI Number Information
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NPI Number | 1205322039
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Entity Type | Organization
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Legal Business Name | AMERICAN MED GLOBAL PARTNER INC
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Dates
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Enumeration Date | 07/04/2018
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Last Update Date | 04/03/2020
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Provider Practice Location Address
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Address Line | 924 2ND ST SW
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City | ROANOKE
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State | VA
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Zip | 24016-4408
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Country | US
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Telephone | 804-980-9801
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Fax |
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Provider Business Mailing Address
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Address Line | 924 2ND ST SW
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City | ROANOKE
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State | VA
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Zip | 24016-4408
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Country | US
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Telephone | 804-980-9801
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MICHAEL C TRUTT
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Credential |
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Telephone | 305-440-7379
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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