KEMPSVILLE PRIMARY MEDICAL CARE CENTER INC NPI 1013187947

NPI Information

KEMPSVILLE PRIMARY MEDICAL CARE CENTER INC is a primary care clinic center in Virginia Bch, VA. KEMPSVILLE PRIMARY MEDICAL CARE CENTER INC NPI is 1013187947. The provider is registered as an organization entity type.

The provider's business location address is:

5136 PRINCESS ANNE RD
VIRGINIA BCH, VA
ZIP 23462-228
Phone: (757) 473-0003
Fax: (757) 497-9510

The provider's authorized official is Josue Apilan Miranda .
The authorized official title is Owner and has the following contact phone number (757) 473-0003.

The CLIA number assigned to this NPI record is 49D0229162 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/6/2008 and was last updated on 3/7/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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