Provider Demographics
NPI:1609808484
Name:BUCHANAN HEALTH CARE LLC
Entity Type:Organization
Organization Name:BUCHANAN HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/BUSINESS OFFICE
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-935-1129
Mailing Address - Street 1:PO BOX 669
Mailing Address - Street 2:
Mailing Address - City:GRUNDY
Mailing Address - State:VA
Mailing Address - Zip Code:24614-0669
Mailing Address - Country:US
Mailing Address - Phone:276-935-1167
Mailing Address - Fax:276-935-1219
Practice Address - Street 1:1532 SLATE CREEK ROAD,
Practice Address - Street 2:SUITE 204 MEDICAL OFFICE BLDG, 2ND FLOOR
Practice Address - City:GRUNDY
Practice Address - State:VA
Practice Address - Zip Code:24614
Practice Address - Country:US
Practice Address - Phone:276-935-1167
Practice Address - Fax:276-935-1219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC06265Medicare ID - Type Unspecified