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NPI Code Detail

MEDICARE: JOHNSON HEALTH CENTER

MEDICARE: JOHNSON HEALTH CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QF0400XFederally Qualified Health Center (FQHC)

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2DC4704OTHERVARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316926538
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOHNSON HEALTH CENTER
Provider Business Mailing Address
First Line : 134 ELON RD
Second Line :
City : MADISON HEIGHTS
State : VA
Zip : 24572-2536
Country : US
Telephone Number : 434-455-2480
Fax Number : 434-455-2487
Provider Business Practice Location Address
First Line : 320 FEDERAL ST
Second Line :
City : LYNCHBURG
State : VA
Zip : 24504-2306
Country : US
Telephone Number : 434-947-5967
Fax Number : 434-947-5255
Authorized Official
Title or Position : CEO
Name : GARY CAMPBELL
Credential :
Telephone Number : 434-455-2480
Provider Enumeration Date : 01/16/2006
Last Update Date : 04/07/2015

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Directions to “JOHNSON HEALTH CENTER ” Practice Location

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