| Brackenrich Family Practice, Plc | |
|
363 Woodland Street Rich Creek VA 24147-0336 | |
| (540) 726-2375 | |
| (540) 726-3573 |
| Full Name | Brackenrich Family Practice, Plc |
|---|---|
| Speciality | Family Medicine |
| Location | 363 Woodland Street, Rich Creek, Virginia |
| Authorized Official Name and Position | Michael Brackenrich (OWNER) |
| Authorized Official Contact | 5407262375 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brackenrich Family Practice, Plc Po Box B 363 Woodland Street Rich Creek VA 24147-0336 Ph: (540) 726-2375 | Brackenrich Family Practice, Plc 363 Woodland Street Rich Creek VA 24147-0336 Ph: (540) 726-2375 |
| NPI Number | 1225136021 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 04/11/2024 |
| Medicare PECOS PAC ID | 9739236670 |
|---|---|
| Medicare Enrollment ID | O20090413000289 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225136021 | NPI | - | NPPES |
| 00241766806 | Other | VA | ADVANCED PRACTICE REGISTERED NURSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael Dale Brackenrich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972603744 PECOS PAC ID: 7911054853 Enrollment ID: I20090413000288 |
Brackenrich Family Practice, Plc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 363 Woodland Street, Rich Creek, VA 24147 Phone: 540-726-2375 Fax: 540-726-3573 |