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General NPI Number Information
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NPI Number | 1699781393
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Entity Type | Organization
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Legal Business Name | ALLIANCE FAMILY HEALTH CARE, PC
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 3333 S CRATER RD SUITE 3A
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City | PETERSBURG
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State | VA
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Zip | 23805-9276
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Country | US
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Telephone | 804-733-3438
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Fax | 804-733-7424
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Provider Business Mailing Address
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Address Line | 3333 S CRATER RD SUITE 3A
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City | PETERSBURG
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State | VA
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Zip | 23805-9276
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Country | US
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Telephone | 804-733-3438
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Fax | 804-733-7424
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MRS. ALFREDA BOOKER
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Credential |
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Telephone | 804-323-5575
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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 | 0101038398
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License Number State | VA
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