| Park Place Medical Center | |
|
155 Kingsley Ln Ste 320 Norfolk VA 23505-4629 | |
| (757) 533-9108 | |
| (757) 622-6384 |
| Full Name | Park Place Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 155 Kingsley Ln Ste 320, Norfolk, Virginia |
| Authorized Official Name and Position | Barbara Willis (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7573970042 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Place Medical Center 1541 High St Portsmouth VA 23704-3209 Ph: (757) 393-6363 | Park Place Medical Center 155 Kingsley Ln Ste 320 Norfolk VA 23505-4629 Ph: (757) 533-9108 |
| NPI Number | 1073833760 |
|---|---|
| Provider Enumeration Date | 06/04/2010 |
| Last Update Date | 05/17/2023 |
| Medicare PECOS PAC ID | 1052301835 |
|---|---|
| Medicare Enrollment ID | O20100625000483 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073833760 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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