| Bellgrade Medical, Llc | |
|
2621 Promenade Pkwy Ste 101 Midlothian VA 23113-4905 | |
| (804) 897-3746 | |
| Not Available |
| Full Name | Bellgrade Medical, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2621 Promenade Pkwy Ste 101, Midlothian, Virginia |
| Authorized Official Name and Position | Peter Gent (PRESIDENT) |
| Authorized Official Contact | 8045984799 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bellgrade Medical, Llc 2621 Promenade Pkwy Ste 101 Midlothian VA 23113-4905 Ph: (804) 897-3746 | Bellgrade Medical, Llc 2621 Promenade Pkwy Ste 101 Midlothian VA 23113-4905 Ph: (804) 897-3746 |
| NPI Number | 1326546151 |
|---|---|
| Provider Enumeration Date | 01/26/2018 |
| Last Update Date | 04/04/2018 |
| Medicare PECOS PAC ID | 0840553616 |
|---|---|
| Medicare Enrollment ID | O20180409000274 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326546151 | NPI | - | NPPES |
| 0102032395 | Other | VA | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0102032395 (Virginia) | Primary |
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