| Remedy Clinic | |
|
370 Courthouse Rd Ste 103 Gulfport MS 39507-1889 | |
| (228) 203-1700 | |
| (228) 203-1770 |
| Full Name | Remedy Clinic |
|---|---|
| Speciality | Dentist |
| Location | 370 Courthouse Rd Ste 103, Gulfport, Mississippi |
| Authorized Official Name and Position | Andrea Burger Elenbaas (OWNER) |
| Authorized Official Contact | 2282031700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Remedy Clinic 370 Courthouse Rd Ste 103 Gulfport MS 39507-1889 Ph: (228) 203-1700 | Remedy Clinic 370 Courthouse Rd Ste 103 Gulfport MS 39507-1889 Ph: (228) 203-1700 |
| NPI Number | 1710768643 |
|---|---|
| Provider Enumeration Date | 10/06/2023 |
| Last Update Date | 08/06/2024 |
| Medicare PECOS PAC ID | 0749639102 |
|---|---|
| Medicare Enrollment ID | O20231211001046 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710768643 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X2210X | Dentist - Orofacial Pain | (* (Not Available)) | Primary |
| Provider Name | Andrea Elenbaas |
|---|---|
| Provider Type | Practitioner - Orofacial Pain |
| Provider Identifiers | NPI Number: 1922125947 PECOS PAC ID: 6406173939 Enrollment ID: I20231211001769 |
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