Provider Demographics
NPI:1194361840
Name:ANCHOR HEALTHCARE, PLC
Entity Type:Organization
Organization Name:ANCHOR HEALTHCARE, PLC
Other - Org Name:CHARLOTTESVILLE INTERNAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-227-7588
Mailing Address - Street 1:1410 INCARNATION DR STE 205A
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-5708
Mailing Address - Country:US
Mailing Address - Phone:434-260-0302
Mailing Address - Fax:
Practice Address - Street 1:1410 INCARNATION DR STE 205A
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-5708
Practice Address - Country:US
Practice Address - Phone:434-260-0302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANCHOR HEALTHCARE, PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-11-18
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty