Provider Demographics
NPI:1073752184
Name:THE FAMILY MATERNITY CENTER OF THE NORTHERN NECK, INC.
Entity Type:Organization
Organization Name:THE FAMILY MATERNITY CENTER OF THE NORTHERN NECK, INC.
Other - Org Name:FAMILY MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:C
Authorized Official - Last Name:DODSON-MCADOO
Authorized Official - Suffix:
Authorized Official - Credentials:RN, ANP-C
Authorized Official - Phone:804-435-3504
Mailing Address - Street 1:PO BOX 1866
Mailing Address - Street 2:
Mailing Address - City:KILMARNOCK
Mailing Address - State:VA
Mailing Address - Zip Code:22482-1866
Mailing Address - Country:US
Mailing Address - Phone:804-435-3504
Mailing Address - Fax:804-435-0517
Practice Address - Street 1:101 HARRIS RD
Practice Address - Street 2:MEDICAL BUILDING 6
Practice Address - City:KILMARNOCK
Practice Address - State:VA
Practice Address - Zip Code:22482-3880
Practice Address - Country:US
Practice Address - Phone:804-435-0023
Practice Address - Fax:804-435-0025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-12
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health