The Bolick Clinic, Inc. is a medicare enrolled "Clinic/center - Multi-specialty" provider in Maitland, Florida. Their current practice location is
500 E Horatio Ave, Suite 5, Maitland, Florida. You can reach out to their office (for appointments etc.) via phone at
(407) 629-5333.
The Bolick Clinic, Inc. is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. The Bolick Clinic, Inc.
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1073680088.
Healthcare Provider's Profile
| Full Name | The Bolick Clinic, Inc. |
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| Type | Facility |
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| Speciality | Clinic/center - Multi-specialty |
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| Location | 500 E Horatio Ave, Maitland, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1073680088
- Provider Enumeration Date: 11/29/2006
- Last Update Date: 06/04/2019
Medicare PECOS Information:
- PECOS PAC ID: 4284617119
- Enrollment ID: O20040610001401
Medical Identifiers
Medical identifiers for The Bolick Clinic, Inc. such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1073680088 | NPI | - | NPPES |
| 3819132-00 | Medicaid | FL | |
| 55996 | Other | FL | BLUE CROSS GROUP NUMBER |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Secondary |
| 171100000X | Acupuncturist | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
The Bolick Clinic, Inc. acts as a billing entity for following providers:
| Provider Name | Channing C. Bolick |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1316936206
PECOS PAC ID: 3375526213
Enrollment ID: I20101021000429 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. The Bolick Clinic, Inc. is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
The Bolick Clinic, Inc.
500 E Horatio Ave, Suite 5,
Maitland, FL 32751-7310
Ph: (407) 629-5333 | The Bolick Clinic, Inc.
500 E Horatio Ave, Suite 5,
Maitland, FL 32751-7310
Ph: (407) 629-5333 |
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