Southside Internal Medicine, Pc

LBN: Southside Internal Medicine, Pc
Southside Internal Medicine, Pc is an health care organization with primary practice located at 202 Agee Street , Farmville VA 23901. The organization recently has only one registered license in Managed Care Organizations / Health Maintenance Organization, which is considered as the primary health care specialty. Southside Internal Medicine, Pc can be contacted via phone (434) 392-6143, or through San, Luke via phone (434) 392-6143.

Contact Information

Primary practice address
202 Agee Street Farmville VA 23901
Phone: (434) 392-6143
Fax: (434) 392-3866
Website:
Map and Directions
Authorized official contact:
Name: San, Luke Doctor of Medicine (MD)
Phone: (434) 392-6143

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Health Maintenance Organization 302R00000X 0101048599 Virginia

Profile Details

NPI number 1609065341
LBN Legal business name Southside Internal Medicine, Pc
DBA Doing business as
Authorized official San, Luke Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 18th, 2007
Last updated Jan 19th, 2010 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1609065341 NPPES
Virginia MEDICAID 005849632

Popular Providers