Organization
PENINSULA INSTITUTE FOR COMMUNITY HEALTH INC
Active
Organization
PENINSULA INSTITUTE FOR COMMUNITY HEALTH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA FUTRELL (CHIEF EXECUTIVE OFFICER)
(757) 591-0643
Entity
Organization
Contact information
Practice address
1033 28TH ST, 2ND FLOOR, NEWPORT NEWS, VA 23607-4233
(757) 591-0643
(757) 591-0682
Mailing address
4714 MARSHALL AVE, NEWPORT NEWS, VA 23607-2247
(757) 591-0643
(757) 591-0682
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7687648
—
VA
Enumeration date
01/24/2006
Last updated
10/18/2012
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