Provider Demographics
NPI:1366855207
Name:FREE CLINIC OF CENTRAL VIRGINIA, INC.
Entity Type:Organization
Organization Name:FREE CLINIC OF CENTRAL VIRGINIA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELZINGARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-847-5866
Mailing Address - Street 1:1016 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24504-1712
Mailing Address - Country:US
Mailing Address - Phone:434-847-5866
Mailing Address - Fax:434-582-2529
Practice Address - Street 1:1016 MAIN ST
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24504-1712
Practice Address - Country:US
Practice Address - Phone:434-847-5866
Practice Address - Fax:434-582-2529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental