Organization
INDEPENDENCE FAMILY CARE CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCE LOVELACE DO (PRESIDENT)
(276) 773-2111
Entity
Organization
Contact information
Practice address
217 S INDEPENDENCE AVE, INDEPENDENCE, VA 24348-2802
(276) 773-2111
Mailing address
217 S INDEPENDENCE AVE, INDEPENDENCE, VA 24348-2802
(276) 773-2111
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010134129
—
VA
01
—
143862
BCBS ANTHEM
VA
Enumeration date
03/22/2007
Last updated
11/29/2011
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