| Midlomed Llc | |
|
5930 Harbour Park Dr Midlothian VA 23112-2169 | |
| (804) 893-0337 | |
| (689) 202-0711 |
| Full Name | Midlomed Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5930 Harbour Park Dr, Midlothian, Virginia |
| Authorized Official Name and Position | Gina K Smoot (FAMILY NURSE PRACTITIONER) |
| Authorized Official Contact | 8043751660 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midlomed Llc 5930 Harbour Park Dr Midlothian VA 23112-2169 Ph: (804) 893-0337 | Midlomed Llc 5930 Harbour Park Dr Midlothian VA 23112-2169 Ph: (804) 893-0337 |
| NPI Number | 1114741949 |
|---|---|
| Provider Enumeration Date | 11/08/2024 |
| Last Update Date | 09/02/2025 |
| Medicare PECOS PAC ID | 2466972013 |
|---|---|
| Medicare Enrollment ID | O20250226000476 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114741949 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Gina K Smoot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720720683 PECOS PAC ID: 5193190601 Enrollment ID: I20250226000812 |
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