SANDY RIVER FAMILY CARE INC NPI 1932354222

NPI Information

NPI: 1932354222
Provider Name: SANDY RIVER FAMILY CARE INC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 49D1096368

Address:
4520 MEDICAL CENTER RD
AXTON, VA
ZIP 24054
Phone: (434) 685-7095
Get Directions

SANDY RIVER FAMILY CARE INC is a family medicine in Axton, VA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. SANDY RIVER FAMILY CARE INC NPI is 1932354222. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

4520 MEDICAL CENTER RD
AXTON, VA
ZIP 24054-822
Phone: (434) 685-7095
Fax: (434) 797-1300

The provider's authorized official is Rajendra S Trivedi .
The authorized official title is President and has the following contact phone number (434) 685-7095.

The CLIA number assigned to this NPI record is 49D1096368 - mobile laboratory with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/1/2008 and was last updated on 9/10/2013.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		0101053147	VIRGINIA	Yes

Other Identifiers

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

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	89063VU	OTHER	NORTH CAROLINA	MEDICAID NC
2	G16514	MEDICARE UPIN	VIRGINIA
3	CL9316	OTHER	VIRGINIA	PALMETTO GBA MEDICARE
4	258015	OTHER	VIRGINIA	ANTHEM BC
5	C01226	MEDICARE PIN	VIRGINIA
6	005619505	MEDICAID	VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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