Provider Demographics
NPI:1457840241
Name:CHRONIC CARE PARTNERS LLC
Entity Type:Organization
Organization Name:CHRONIC CARE PARTNERS LLC
Other - Org Name:CHRONIC CARE PARTNERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:FOUAD
Authorized Official - Middle Name:
Authorized Official - Last Name:FAROOQI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-520-3507
Mailing Address - Street 1:112 S PROVIDENCE RD STE 103
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236-3300
Mailing Address - Country:US
Mailing Address - Phone:540-520-3507
Mailing Address - Fax:800-676-9961
Practice Address - Street 1:112 S PROVIDENCE RD STE 103
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-3300
Practice Address - Country:US
Practice Address - Phone:540-520-3507
Practice Address - Fax:800-676-9961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-07
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA101239733207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty