Provider Demographics
NPI:1851059216
Name:TELAWATCH HEALTH LLC
Entity type:Organization
Organization Name:TELAWATCH HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:GOAD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:540-488-2200
Mailing Address - Street 1:1013 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-4419
Mailing Address - Country:US
Mailing Address - Phone:540-488-2200
Mailing Address - Fax:888-500-1891
Practice Address - Street 1:1013 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-4419
Practice Address - Country:US
Practice Address - Phone:540-488-2200
Practice Address - Fax:888-500-1891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty