Organization
PCH EXPRESS CARE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANICE F. WILKINS (ADMINISTRATOR)
(276) 694-8678
Entity
Organization
Contact information
Practice address
18688 JEB STUART HWY, STUART, VA 24171-1559
(276) 694-3151
(276) 694-8655
Mailing address
18688 JEB STUART HWY, STUART, VA 24171-1559
(276) 694-3151
(276) 694-8655
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
H1919
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010135583
—
VA
01
—
146602
ANTHEM
VA
01
—
330049
MAMSI
VA
Enumeration date
01/18/2007
Last updated
06/20/2008
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