Provider Demographics
NPI:1912949660
Name:EMERGICARE INC.
Entity Type:Organization
Organization Name:EMERGICARE INC.
Other - Org Name:PATIENT CARE PLUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHELBY
Authorized Official - Middle Name:CAMPBELL
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-885-6789
Mailing Address - Street 1:42 LAMBERT ST STE 111
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-2421
Mailing Address - Country:US
Mailing Address - Phone:540-885-6789
Mailing Address - Fax:540-886-7364
Practice Address - Street 1:42 LAMBERT ST STE 111
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-2421
Practice Address - Country:US
Practice Address - Phone:540-885-6789
Practice Address - Fax:540-886-7364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010061571Medicaid
VA010235421Medicaid
VA003666E50Medicare ID - Type Unspecified
VAF32132Medicare UPIN
VAQ51963Medicare UPIN
VA010061571Medicaid