| Guadalupe Wooster | |
|
178 E Milltown Rd Wooster OH 44691-1244 | |
| (330) 439-3261 | |
| Not Available |
| Full Name | Guadalupe Wooster |
|---|---|
| Speciality | Clinic/Center |
| Location | 178 E Milltown Rd, Wooster, Ohio |
| Authorized Official Name and Position | Tyler Scott (PRESIDENT) |
| Authorized Official Contact | 3304393261 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Guadalupe Wooster 1521 Eden Dr Wooster OH 44691-2245 Ph: (330) 439-3261 | Guadalupe Wooster 178 E Milltown Rd Wooster OH 44691-1244 Ph: (330) 439-3261 |
| NPI Number | 1033831094 |
|---|---|
| Provider Enumeration Date | 09/16/2022 |
| Last Update Date | 09/16/2022 |
| Medicare PECOS PAC ID | 4981067949 |
|---|---|
| Medicare Enrollment ID | O20230824001689 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033831094 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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