Provider Demographics
NPI:1699831511
Name:MEL LEAMAN FREE CLINIC AT EMORY & HENRY COLLEGE, INC.
Entity Type:Organization
Organization Name:MEL LEAMAN FREE CLINIC AT EMORY & HENRY COLLEGE, INC.
Other - Org Name:SMYTH COUNTY FREE CLINIC, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:ARMBRISTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-706-8478
Mailing Address - Street 1:601 RADIO HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:VA
Mailing Address - Zip Code:24354
Mailing Address - Country:US
Mailing Address - Phone:276-781-2090
Mailing Address - Fax:276-781-0866
Practice Address - Street 1:601 RADIO HILL ROAD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:VA
Practice Address - Zip Code:24354
Practice Address - Country:US
Practice Address - Phone:276-781-2090
Practice Address - Fax:276-781-0866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care