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General NPI Number Information
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NPI Number | 1477751915
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Entity Type | Organization
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Legal Business Name | ELKTON FAMILY AND CHILDRENS MEDICAL CLINIC
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Dates
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Enumeration Date | 07/06/2007
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Last Update Date | 12/23/2010
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Provider Practice Location Address
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Address Line | 115 E ROCKINGHAM ST
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City | ELKTON
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State | VA
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Zip | 22827-1522
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Country | US
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Telephone | 540-298-9900
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Fax | 540-298-8991
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Provider Business Mailing Address
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Address Line | 115 E ROCKINGHAM ST
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City | ELKTON
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State | VA
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Zip | 22827-1522
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Country | US
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Telephone | 540-298-9900
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Fax | 540-298-8991
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. PETER GRAYSON HILL
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Credential | FNP
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Telephone | 540-298-9900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number | 0024166329
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License Number State | VA
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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 | 0024166329
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License Number State | VA
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