Organization
MILL MOUNTAIN EMERGENCY GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISHA C FALK (VP OF CONTRACTING)
(800) 893-9698
Entity
Organization
Contact information
Practice address
2706 OGDEN RD, CAVE SPRING, VA 24018-0600
(540) 970-8000
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
Other
Enumeration date
06/06/2018
Last updated
06/06/2018
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