Organization
PENINSULA INSTITUTE FOR COMMUNITY HEALTH INC
Active
Organization
PENINSULA INSTITUTE FOR COMMUNITY HEALTH INC
Active
Other names
Stoneybrook Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA FUTRELL (CHIEF EXECUTIVE OFFICER)
(757) 591-0643
Entity
Organization
Contact information
Practice address
15425H WARWICK BLVD, NEWPORT NEWS, VA 23608
(757) 874-8400
(757) 874-2295
Mailing address
1033 28TH ST, 2ND FLOOR, NEWPORT NEWS, VA 23607-4233
(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
—
007687648
—
VA
Enumeration date
03/13/2007
Last updated
09/24/2010
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