Organization
PRIMARY HEALTH GROUP INC
Active
Other names
Physicians of Family Medicine-Cloverhill
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL SMITH (VP)
(804) 237-7760
Entity
Organization
Contact information
Practice address
13861 HULL STREET RD, MIDLOTHIAN, VA 23112-2003
(804) 739-0910
(804) 739-2763
Mailing address
13861 HULL STREET RD, MIDLOTHIAN, VA 23112-2003
(804) 739-0910
(804) 739-2763
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144347378
—
VA
01
—
CE1200
RR MEDICARE
—
Enumeration date
03/23/2007
Last updated
12/18/2007
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