WASHINGTON SQUARE CLINIC INC; NPI #1508943507

Contact Information

WASHINGTON SQUARE CLINIC INC

3150 CLINCH ST
RICHLANDS, VA 24641

Phone: 276-964-6711
Fax: 276-964-2240
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Multi-Specialty	261QM1300X	70	Clinic or Group Practice

Indicates primary specialty

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NPI Profile & details for WASHINGTON SQUARE CLINIC INC

NPI # 1508943507

LBN Legal business name WASHINGTON SQUARE CLINIC INC

Authorized official TUSHAR PATEL - (PRESIDENT WASHINGTON SQUARE CLINIC)

Entity Organization

Organization subpart ¹ No

Enumeration date 11/01/2006

Last updated 05/22/2008 - About 18 years ago

Identifiers

VA	Medicaid	006034951
VA	Medicaid	007330146
	Other	5545395	AETNA
	Other	049118	BLUE CROSS BLUE SHIELD
	Other	049120	BLUE CROSS BLUE SHIELD
	Other	068118	BLUE CROSS BLUE SHIELD
	Other	068119	BLUE CROSS BLUE SHIELD
	Other	137286	BLUE CROSS BLUE SHIELD
	Other	027996700	FEDERAL BLACK LUNG
	Other	001709083	MTN STATE BC
	Other	CG0014	RAILROAD MEDICARE GROUP
	Other	1499361	UMWA
VA	Other	049115	BCBS

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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