Buchanan Health Diabetes Center
Organization Active NPI Specialist · Grundy, VA
NPI 1376809384 · NPPES record last updated Apr 3, 2012
Key facts
- NPI
- 1376809384
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- Legal business name
- BUCHANAN HEALTH DIABETES CENTER
- Practice address
- 1532 Slate Creek Rd
Suite 101
Grundy, VA 24614-6975 - Phone
- (276) 935-2080
- NPI assigned
- Apr 3, 2012
- Organization subpart
- Yes
- Parent organization (as reported)
- BUCHANAN HEALTH CENTER
Authorized official
- Name
- Arvil R Ratliff
- Title
- Ceo
- Phone
- (276) 935-2080
Parent organization (reported in NPPES) 1
Other NPIs on the same Medicare enrollment 1
Practitioners 4
-
Rachel Ann Fuller, FNP
-
Dedra Denise Crouse, FNP
-
Janet Susan Elswick, FNP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 49D1036851 | Buchanan Health Center, Inc | Certificate of waiver | Feb 9, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050318000336 | VA | Part B Supplier - Clinic/Group Practice | 1254386659 |
Receives reassigned benefits from 4 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Grundy, VA |
National Provider Directory
- Part of
- Buchanan Health Center Inc
Locations
1532 Slate Creek Rd
Ste 101
Grundy, VA 24614
Phone (276) 935-2080
1532 Slate Creek Rd
#101
Grundy, VA 24614
Phone (276) 935-2080
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | Yes |
Addresses
Primary practice location
1532 Slate Creek Rd
Suite 101
Grundy, VA 24614-6975
Mailing address
PO Box 1217
Grundy, VA 24614-1217
Phone (276) 935-2080
Other providers in Grundy, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 3, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.