Provider Demographics
NPI:1497648661
Name:MARTINSVILLE PRIMARY CARE LLC
Entity type:Organization
Organization Name:MARTINSVILLE PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDYTHE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:BOITNOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:276-618-1236
Mailing Address - Street 1:106 SALMON ST
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-3211
Mailing Address - Country:US
Mailing Address - Phone:276-634-0010
Mailing Address - Fax:276-632-0120
Practice Address - Street 1:106 SALMON ST
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-3211
Practice Address - Country:US
Practice Address - Phone:276-634-0010
Practice Address - Fax:276-632-0120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care