| Ch Va Collaborative Care Llc | |
|
4099 Basswood Rd Disputanta VA 23842-4517 | |
| (571) 781-7001 | |
| (888) 722-4282 |
| Full Name | Ch Va Collaborative Care Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4099 Basswood Rd, Disputanta, Virginia |
| Authorized Official Name and Position | Melissa M Cooke (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 9727153808 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ch Va Collaborative Care Llc 4055 Valley View Ln Suite 400 Dallas TX 75244-5074 Ph: (972) 715-3800 | Ch Va Collaborative Care Llc 4099 Basswood Rd Disputanta VA 23842-4517 Ph: (571) 781-7001 |
| NPI Number | 1184025439 |
|---|---|
| Provider Enumeration Date | 09/05/2014 |
| Last Update Date | 02/10/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184025439 | NPI | - | NPPES |
| E110 | Other | VA | MEDICARE CERTIFICATION NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |