| NPI | 1750619326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULETTE MAURINE MCELWAIN CEO 804-355-4358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: VA 00474940) |
| Additional Taxonomies | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: VA 0201003140) |
| Enumeration Date | 2009-11-19 |
| Last Update Date | 2018-04-10 |