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NPI Code Detail

MEDICARE: UNIVERSAL COMPLETE CARE PC

MEDICARE: UNIVERSAL COMPLETE CARE PC
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
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1992439889
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNIVERSAL COMPLETE CARE PC
Provider Business Mailing Address
First Line : PO BOX 8310
Second Line :
City : ROANOKE
State : VA
Zip : 24014-0310
Country : US
Telephone Number : 540-345-3556
Fax Number : 540-342-2193
Provider Business Practice Location Address
First Line : 1945 ROANOKE BLVD
Second Line :
City : SALEM
State : VA
Zip : 24153-6408
Country : US
Telephone Number : 540-769-3964
Fax Number : 540-318-2500
Authorized Official
Title or Position : PRESDIENT
Name : ALFONSO BROCHERO
Credential :
Telephone Number : 540-769-3964
Provider Enumeration Date : 07/15/2022
Last Update Date : 10/11/2022

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Directions to “UNIVERSAL COMPLETE CARE PC ” Practice Location

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