Provider Demographics
NPI:1619274446
Name:ROANOKE VALLEY HEALTHCARE PARTNERS, LLC
Entity Type:Organization
Organization Name:ROANOKE VALLEY HEALTHCARE PARTNERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:G
Authorized Official - Last Name:GILLIAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-222-9299
Mailing Address - Street 1:PO BOX 2022
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27216-2022
Mailing Address - Country:US
Mailing Address - Phone:336-222-9299
Mailing Address - Fax:336-222-9168
Practice Address - Street 1:602 BRANDON AVE SW
Practice Address - Street 2:SUITE 222
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24015-3212
Practice Address - Country:US
Practice Address - Phone:540-774-0000
Practice Address - Fax:540-774-0085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-14
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care