Provider Demographics
NPI:1851931877
Name:HOPE CLINIC OF FARMVILLE
Entity Type:Organization
Organization Name:HOPE CLINIC OF FARMVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:J
Authorized Official - Last Name:WINGO
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:434-394-2422
Mailing Address - Street 1:PO BOX 585
Mailing Address - Street 2:
Mailing Address - City:FARMVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23901-0585
Mailing Address - Country:US
Mailing Address - Phone:434-394-2422
Mailing Address - Fax:434-394-2435
Practice Address - Street 1:1100 W 3RD ST
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901-2628
Practice Address - Country:US
Practice Address - Phone:434-394-2422
Practice Address - Fax:434-394-2435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-07
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care