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LIVEWELL PASSPORT OF VA LLC NPI 1366136418


NPI Information

NPI: 1366136418
Provider Name: LIVEWELL PASSPORT OF VA LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
13553 MIDLOTHIAN TPKE
MIDLOTHIAN, VA
ZIP 23113
Phone: (804) 229-1554
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LIVEWELL PASSPORT OF VA LLC is a family medicine in Midlothian, VA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. LIVEWELL PASSPORT OF VA LLC NPI is 1366136418. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

13553 MIDLOTHIAN TPKE
MIDLOTHIAN, VA
ZIP 23113-261
Phone: (804) 229-1554
Fax: (844) 777-1754

The provider's authorized official is Jeremiah D Fabry .
The authorized official title is Manager and has the following contact phone number (804) 229-1554.

The enumeration date for this NPI number is 6/2/2023 and was last updated on 6/2/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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