Provider Demographics
NPI:1245662022
Name:CLINCH VALLEY PHYSICIANS ASSOCIATES LLC
Entity type:Organization
Organization Name:CLINCH VALLEY PHYSICIANS ASSOCIATES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-920-7000
Mailing Address - Street 1:1 CLINIC DR
Mailing Address - Street 2:CLAYPOOL HILL
Mailing Address - City:RICHLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:24641-1102
Mailing Address - Country:US
Mailing Address - Phone:276-964-1267
Mailing Address - Fax:276-964-1208
Practice Address - Street 1:1 CLINIC DR
Practice Address - Street 2:CLAYPOOL HILL
Practice Address - City:RICHLANDS
Practice Address - State:VA
Practice Address - Zip Code:24641-1102
Practice Address - Country:US
Practice Address - Phone:276-964-1267
Practice Address - Fax:276-964-1208
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLINCH VALLEY PHYSICIANS ASSOCIATES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-05
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies