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NPI Code Detail

MEDICARE: VALLEY GERICARE INC

MEDICARE: VALLEY GERICARE INC
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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1437482460
Entity Type Code : Organization
Provider Name (Legal Business Name) : VALLEY GERICARE INC
Provider Business Mailing Address
First Line : 424 GRAVES MILL RD
Second Line : SUITE 400
City : LYNCHBURG
State : VA
Zip : 24502-4651
Country : US
Telephone Number : 434-846-3832
Fax Number : 434-846-7218
Provider Business Practice Location Address
First Line : 4355 PHEASANT RIDGE RD
Second Line :
City : ROANOKE
State : VA
Zip : 24014-5272
Country : US
Telephone Number : 540-725-8210
Fax Number :
Authorized Official
Title or Position : OWNER
Name : WILLIAM C WARD
Credential : MD
Telephone Number : 540-493-7200
Provider Enumeration Date : 09/09/2009
Last Update Date : 09/09/2009

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