Provider Demographics
NPI:1902005366
Name:ABINGDON FAMILY HEALTHCARE, INC.
Entity Type:Organization
Organization Name:ABINGDON FAMILY HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:G
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-628-3144
Mailing Address - Street 1:445 PORTERFIELD HWY SW
Mailing Address - Street 2:SUITE A
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-2556
Mailing Address - Country:US
Mailing Address - Phone:276-628-3144
Mailing Address - Fax:276-628-1571
Practice Address - Street 1:445 PORTERFIELD HWY SW
Practice Address - Street 2:SUITE A
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-2556
Practice Address - Country:US
Practice Address - Phone:276-628-3144
Practice Address - Fax:276-628-1571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA=========OtherEMPLOYER ID NUMBER