DICKENSON AFTER HOURS CLINIC, INC (NPI# 1174958110) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174958110 |
| Entity Type | Organization |
| Organization Name | DICKENSON AFTER HOURS CLINIC, INC |
| Practice Address |
5607 Dickenson Hwy Clintwood VA 24228-7009 |
| Mailing Address |
Po Box 2224 Clintwood VA 24228-2224 |
| Practice Telephone | 2769264601 |
| Practice Fax Number | 2769264602 |
| Mailing Telephone | 2769264601 |
| Mailing Fax Number | 2769264602 |
| Enumeration Date | 2013-09-10 |
| Last Update Date | 2014-01-15 |
| Authorized Official Name | RIMON IBRAHIM (ADMINISTRATOR) |
| Authorized Official Telephone | 2769264601 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
5607 DICKENSON HWY |
| City | CLINTWOOD |
| State | VA |
| Zip Code | 24228-7009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033153879 | Dickenson Medical Clinic PC | Clinic/Center | 5607 Dickenson Hwy, Clintwood, VA 24228-7009 | 2006-06-15 |
| 1861809410 | Jessica Faye Rasnick | Nurse Practitioner | 5607 Dickenson Hwy, Clintwood, VA 24228-7009 | 2014-07-15 |
| 1720355977 | Leslie A Davis | Nurse Practitioner | 5607 Dickenson Hwy, Clintwood, VA 24228 | 2011-11-16 |
| 1316246242 | Annabelle Lee Pannell | Nurse Practitioner | 5607 Dickenson Hwy, Clintwood, VA 24228-7009 | 2011-03-17 |
| 1588811103 | Carla Fleming | Nurse Practitioner | 5607 Dickenson Hwy, Clintwood, VA 24228-7009 | 2008-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851816953 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 5451 Dickenson Hwy, Clintwood, VA 24228 | 2017-08-09 |
| 1669902243 | Mountain States Health Alliance | Hospice Care, Community Based | 312 Hospital Dr Suite 1b, Clintwood, VA 24228 | 2017-06-15 |
| 1316476211 | Mountain States Health Alliance | Home Health | 312 Hospital Dr Suite 1a, Clintwood, VA 24228 | 2017-06-06 |
| 1134667009 | Amy Meade | Pharmacist | 342 Main Street, Clintwood, VA 24228 | 2017-02-10 |
| 1881087385 | Family Preservation Services, Inc | Community/Behavioral Health | 1381 Rose Ridge Ct, Clintwood, VA 24228 | 2015-03-09 |
| 1477951515 | Tauna Gulley | Nurse Practitioner | 233 Chase Street, Suite 100, Clintwood, VA 24228 | 2014-12-05 |
| 1740696152 | Family Preservation Services, Inc. | Community/Behavioral Health | 5123 Dickenson Highway, Clintwood, VA 24228 | 2014-07-07 |
| 1962816884 | Family Preservation Services, Inc | Community/Behavioral Health | 5123 & 5127 Dickenson Highway, Clintwood, VA 24228 | 2014-06-18 |
| 1003163643 | Family Preservation Services, Inc | Community/Behavioral Health | 150 Elementary Circle, Clintwood, VA 24228 | 2012-08-14 |
| 1265739122 | Family Preservation Services, Inc. | Community/Behavioral Health | Technology Park Drive, Clintwood, VA 24228 | 2011-02-11 |
| Find all providers in zip 24228 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033153879 | Dickenson Medical Clinic PC | Clinic/Center | 5607 Dickenson Hwy, Clintwood, VA 24228-7009 | 2006-06-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.