Provider Demographics
NPI:1760734503
Name:EPIC HEALTH PARTNERS, LLC
Entity Type:Organization
Organization Name:EPIC HEALTH PARTNERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CORY
Authorized Official - Middle Name:DESHA
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-429-1262
Mailing Address - Street 1:157 DEER RUN RD.
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540-2863
Mailing Address - Country:US
Mailing Address - Phone:434-835-4601
Mailing Address - Fax:434-835-4673
Practice Address - Street 1:108 HOLBROOK ST
Practice Address - Street 2:SUITE 201
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-1758
Practice Address - Country:US
Practice Address - Phone:434-835-4601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization