| Experienced Care Clinic Inc. | |
|
8008 Main St Pound VA 24279-0000 | |
| (276) 796-4586 | |
| Not Available |
| Full Name | Experienced Care Clinic Inc. |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 8008 Main St, Pound, Virginia |
| Authorized Official Name and Position | Tammy Branham (OWNER) |
| Authorized Official Contact | 2763938284 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Experienced Care Clinic Inc. Po Box 908 Pound VA 24279-0908 | Experienced Care Clinic Inc. 8008 Main St Pound VA 24279-0000 Ph: (276) 796-4586 |
| NPI Number | 1285079558 |
|---|---|
| Provider Enumeration Date | 05/01/2013 |
| Last Update Date | 09/11/2024 |
| Certification Date | 09/04/2024 |
| Medicare PECOS PAC ID | 2668616939 |
|---|---|
| Medicare Enrollment ID | O20130926000727 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285079558 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 207QA0401X | Family Medicine - Addiction Medicine | () | Secondary |
| 363LF0000X | Nurse Practitioner - Family | () | Primary |
| Provider Name | Tammy a Branham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518218528 PECOS PAC ID: 3375736812 Enrollment ID: I20130926000788 |
Pound Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11313 Highland Ave, Pound, VA 24279 Phone: 276-796-8100 |