Provider Demographics
NPI:1558375139
Name:FAMILY MEDICAL CARE, INC.
Entity Type:Organization
Organization Name:FAMILY MEDICAL CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:PENDLETON
Authorized Official - Last Name:MCPHERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:276-728-3196
Mailing Address - Street 1:PO BOX 38
Mailing Address - Street 2:
Mailing Address - City:HILLSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24343-0038
Mailing Address - Country:US
Mailing Address - Phone:276-728-3196
Mailing Address - Fax:276-728-4802
Practice Address - Street 1:1953 CARROLLTON PIKE
Practice Address - Street 2:
Practice Address - City:HILLSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24343-0038
Practice Address - Country:US
Practice Address - Phone:276-728-3196
Practice Address - Fax:276-728-4802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA016177OtherANTHEM
VAC00969Medicare PIN
VAB09376Medicare UPIN