Organization
ELITE PRIMARY CARE AND TCM SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELLA RUSSELL (OWNER)
(804) 467-1628
Entity
Organization
Contact information
Practice address
4795 BETHLEHEM RD STE G, RICHMOND, VA 23230-2516
(804) 467-1628
(804) 716-1311
Mailing address
4795 BETHLEHEM RD STE G, RICHMOND, VA 23230-2516
(804) 467-1628
(804) 716-1311
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/29/2023
Last updated
07/26/2024
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