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Contact Information

BRACKENRICH FAMILY PRACTICE, PLC
363 WOODLAND STREET
RICH CREEK, VA24147
 Phone: 540-726-2375
 Fax: 540-726-3573
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for BRACKENRICH FAMILY PRACTICE, PLC

NPI Number 1235229576
LBN Legal business name BRACKENRICH FAMILY PRACTICE, PLC
Authorized official KATHRYN FERGUSON - (ADMINISTRATIVE ASSISTANT)
Entity Organization
Organization subpart 1 No
Enumeration date 10/16/2006
Last updated 02/20/2024 - About 2 years ago
Identifiers
WV Medicaid 0007995002
VA Other 49D0231961 CLIA NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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