| Memorial Family Care Inc | |
|
501 Rison St Suite 120 Danville VA 24541-2425 | |
| (434) 792-3730 | |
| (434) 792-6048 |
| Full Name | Memorial Family Care Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 501 Rison St, Danville, Virginia |
| Authorized Official Name and Position | Tamara R Neal (BILLING MANAGER) |
| Authorized Official Contact | 4347923730 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Memorial Family Care Inc Po Box 10399 Danville VA 24543-5007 Ph: (434) 792-3730 | Memorial Family Care Inc 501 Rison St Suite 120 Danville VA 24541-2425 Ph: (434) 792-3730 |
| NPI Number | 1376510644 |
|---|---|
| Provider Enumeration Date | 03/04/2006 |
| Last Update Date | 04/18/2013 |
| Medicare PECOS PAC ID | 4486600194 |
|---|---|
| Medicare Enrollment ID | O20050325000217 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376510644 | NPI | - | NPPES |
| 89063VU | Other | NC | EDS NC MEDICAID |
| 258015 | Other | VA | ANTHEM |
| CL9316 | Other | VA | PALMETTO GBA MEDICARE |
| 005619505 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0101053147 (Virginia) | Primary |
| Provider Name | Rajendra S Trivedi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740222843 PECOS PAC ID: 6800810953 Enrollment ID: I20080408000864 |
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