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General NPI Number Information
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NPI Number | 1366041170
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Entity Type | Organization
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Legal Business Name | FRIENDSHIP PHYSICIAN CLINIC INC
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Dates
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Enumeration Date | 10/22/2020
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Last Update Date | 01/26/2023
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Provider Practice Location Address
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Address Line | 391 HERSHBERGER RD
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City | ROANOKE
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State | VA
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Zip | 24012-1983
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Country | US
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Telephone | 540-384-5977
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Fax |
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Provider Business Mailing Address
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Address Line | 391 HERSHBERGER RD
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City | ROANOKE
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State | VA
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Zip | 24012-1983
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Country | US
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Telephone | 540-265-2087
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Fax | 540-212-6357
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Authorized Official
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Title or Position | PESIDENT/CEO
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Name | JOSEPH M HOFF
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Credential |
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Telephone | 540-265-2087
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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