WASHINGTON SQUARE CLINIC INC NPI 1508943507

NPI Information

NPI: 1508943507
Provider Name: WASHINGTON SQUARE CLINIC INC
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
3150 CLINCH ST
RICHLANDS, VA
ZIP 24641
Phone: (276) 964-6711
Get Directions

WASHINGTON SQUARE CLINIC INC is a multi-specialty clinic center in Richlands, VA. WASHINGTON SQUARE CLINIC INC NPI is 1508943507. The provider is registered as an organization entity type.

The provider's business location address is:

3150 CLINCH ST
RICHLANDS, VA
ZIP 24641
Phone: (276) 964-6711
Fax: (276) 964-2240

The provider's authorized official is Tushar G Patel .
The authorized official title is President Washington Square Clinic and has the following contact phone number (276) 964-6711.

The enumeration date for this NPI number is 11/1/2006 and was last updated on 5/22/2008.

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
1	261QM1300X	Clinic/Center	Multi-Specialty			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	049120	OTHER		BLUE CROSS BLUE SHIELD
2	027996700	OTHER		FEDERAL BLACK LUNG
3	049118	OTHER		BLUE CROSS BLUE SHIELD
4	020000579	MEDICARE ID-TYPE UNSPECIFIED		STEVEN R HOEBELHEINRICH
5	CG0014	OTHER		RAILROAD MEDICARE GROUP
6	009380W17	MEDICARE ID-TYPE UNSPECIFIED		RAVI K TITHA MD
7	C02117	MEDICARE PIN	VIRGINIA
8	5545395	OTHER		AETNA
9	049115	OTHER	VIRGINIA	BCBS
10	068119	OTHER		BLUE CROSS BLUE SHIELD
11	001709083	OTHER		MTN STATE BC
12	1499361	OTHER		UMWA
13	060000391	MEDICARE ID-TYPE UNSPECIFIED		MULJIBHAI J THAKKAR MD
14	110001963	MEDICARE ID-TYPE UNSPECIFIED		TUSHAR G PATEL MD
15	137286	OTHER		BLUE CROSS BLUE SHIELD
16	068118	OTHER		BLUE CROSS BLUE SHIELD
17	080001667	MEDICARE ID-TYPE UNSPECIFIED		JAMES H MCVEY MD
18	500000523	MEDICARE ID-TYPE UNSPECIFIED		DONNA DAVIS FNP
19	007330146	MEDICAID	VIRGINIA
20	006034951	MEDICAID	VIRGINIA

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

NPI Synchronization or Removal

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