Provider Demographics
NPI:1972699346
Name:FAMILY CARE CENTER INC
Entity type:Organization
Organization Name:FAMILY CARE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:F
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-239-8104
Mailing Address - Street 1:21556D TIMBERLAKE RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-7234
Mailing Address - Country:US
Mailing Address - Phone:434-239-8104
Mailing Address - Fax:434-239-4312
Practice Address - Street 1:21556D TIMBERLAKE RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-7234
Practice Address - Country:US
Practice Address - Phone:434-239-8104
Practice Address - Fax:434-239-4312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101040584207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1679667174OtherNPI
VA197594OtherANTHEM
VAF2012OtherRAILROAD GROUP NUMBER
VAC01732OtherMEDICARE GROUP NUMBER
VA035241OtherANTHEM
VA1205921210OtherNPI
VAC01732OtherMEDICARE GROUP NUMBER
VA1679667174OtherNPI