Provider Demographics
NPI:1851940175
Name:FAMILY FIRST MEDICAL PC
Entity Type:Organization
Organization Name:FAMILY FIRST MEDICAL PC
Other - Org Name:FAMILY FIRST MEDICAL PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MONA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPEAK
Authorized Official - Suffix:
Authorized Official - Credentials:DNP,FNP-BC
Authorized Official - Phone:276-546-5600
Mailing Address - Street 1:PO BOX 556
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON GAP
Mailing Address - State:VA
Mailing Address - Zip Code:24277-0556
Mailing Address - Country:US
Mailing Address - Phone:276-546-5600
Mailing Address - Fax:877-765-6483
Practice Address - Street 1:282 WESTGATE MALL CIR
Practice Address - Street 2:
Practice Address - City:PENNINGTON GAP
Practice Address - State:VA
Practice Address - Zip Code:24277-0030
Practice Address - Country:US
Practice Address - Phone:276-546-5600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-09
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center