| Boffo, LLC | |
|
313 Cheswick Ln Henrico VA 23229-7661 | |
| (804) 396-0372 | |
| Not Available |
| Full Name | Boffo, LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 313 Cheswick Ln, Henrico, Virginia |
| Authorized Official Name and Position | Stephen M Lane (PRESIDENT) |
| Authorized Official Contact | 8043960372 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Boffo, LLC 313 Cheswick Ln Henrico VA 23229-7661 Ph: (804) 396-0372 | Boffo, LLC 313 Cheswick Ln Henrico VA 23229-7661 Ph: (804) 396-0372 |
| NPI Number | 1316672462 |
|---|---|
| Provider Enumeration Date | 07/22/2022 |
| Last Update Date | 07/22/2022 |
| Certification Date | 07/22/2022 |
| Medicare PECOS PAC ID | 0244614881 |
|---|---|
| Medicare Enrollment ID | O20220831002857 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316672462 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Stephen M Lane |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205127859 PECOS PAC ID: 4981845948 Enrollment ID: I20140623000605 |
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