Provider Demographics
NPI:1326404203
Name:TAZEWELL FAMILY HEALTH, INC.
Entity Type:Organization
Organization Name:TAZEWELL FAMILY HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:E
Authorized Official - Last Name:BREWSTER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:276-385-0279
Mailing Address - Street 1:840 E FINCASTLE TPKE
Mailing Address - Street 2:
Mailing Address - City:TAZEWELL
Mailing Address - State:VA
Mailing Address - Zip Code:24651-1419
Mailing Address - Country:US
Mailing Address - Phone:276-385-0279
Mailing Address - Fax:
Practice Address - Street 1:840 E FINCASTLE TPKE
Practice Address - Street 2:
Practice Address - City:TAZEWELL
Practice Address - State:VA
Practice Address - Zip Code:24651-1419
Practice Address - Country:US
Practice Address - Phone:276-385-0279
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-08
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024171492261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1134543911OtherINDIVIDUAL NPI