| Bay Medical & Wellness, Llc | |
|
13794 Tidewater Trl Saluda VA 23149-2314 | |
| (804) 586-3700 | |
| Not Available |
| Full Name | Bay Medical & Wellness, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 13794 Tidewater Trl, Saluda, Virginia |
| Authorized Official Name and Position | Shannon Lee Stone (FAMILY NURSE PRACTITIONER/OWNER) |
| Authorized Official Contact | 8042869377 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bay Medical & Wellness, Llc Po Box 95 Hartfield VA 23071-0095 Ph: () - | Bay Medical & Wellness, Llc 13794 Tidewater Trl Saluda VA 23149-2314 Ph: (804) 586-3700 |
| NPI Number | 1134735905 |
|---|---|
| Provider Enumeration Date | 09/17/2020 |
| Last Update Date | 07/24/2021 |
| Medicare PECOS PAC ID | 6608288931 |
|---|---|
| Medicare Enrollment ID | O20201210001629 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134735905 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Shannon Lee Stone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689066292 PECOS PAC ID: 2860783214 Enrollment ID: I20160615001831 |
Riverside Physician Services Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 672 Gloucester Road, Saluda, VA 23149 Phone: 804-758-2363 Fax: 804-758-3857 |