MEDICARE: NOW FAITH THAT WORKS CHRISTIAN CHURCH

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
1	251S00000X	Community/Behavioral Health Agency	0904003479	VA
2	251V00000X	Voluntary or Charitable Agency

General Provider Information

NPI Number	:	1487982864
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOW FAITH THAT WORKS CHRISTIAN CHURCH

Provider Business Mailing Address
First Line	:	PO BOX 3844
Second Line	:
City	:	CHESTER
State	:	VA
Zip	:	23831-8470
Country	:	US
Telephone Number	:	804-957-6389
Fax Number	:	804-957-6389

Provider Business Practice Location Address
First Line	:	5923 CHURCH RD
Second Line	:
City	:	PETERSBURG
State	:	VA
Zip	:	23803-4534
Country	:	US
Telephone Number	:	804-957-6389
Fax Number	:	804-957-6389

Authorized Official
Title or Position	:	ORDAINED PASTOR
Name	:	MR. KEITH B JONES
Credential	:	PASTOR
Telephone Number	:	804-957-6389

Provider Enumeration Date	:	11/24/2009
Last Update Date	:	02/07/2014

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