Provider Demographics
NPI:1457759250
Name:PIONEER BIRTH AND FAMILY CARE CENTER, PLLC
Entity Type:Organization
Organization Name:PIONEER BIRTH AND FAMILY CARE CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERRIE
Authorized Official - Middle Name:JEANIENE
Authorized Official - Last Name:DOSS
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, WHNP, CNM
Authorized Official - Phone:276-620-6341
Mailing Address - Street 1:2692 POPE RD
Mailing Address - Street 2:
Mailing Address - City:IVANHOE
Mailing Address - State:VA
Mailing Address - Zip Code:24350-3614
Mailing Address - Country:US
Mailing Address - Phone:276-637-3040
Mailing Address - Fax:276-637-3041
Practice Address - Street 1:2692 POPE RD
Practice Address - Street 2:
Practice Address - City:IVANHOE
Practice Address - State:VA
Practice Address - Zip Code:24350-3614
Practice Address - Country:US
Practice Address - Phone:276-637-3040
Practice Address - Fax:276-637-3041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-09
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1285628834Medicaid