| Camellia Place Healthcare Services Llc | |
|
100 Market Sq Ste 12 Newington CT 06111-2921 | |
| (860) 322-1011 | |
| Not Available |
| Full Name | Camellia Place Healthcare Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 100 Market Sq Ste 12, Newington, Connecticut |
| Authorized Official Name and Position | Camille A Payne (NURSE PRACTITIONER) |
| Authorized Official Contact | 8603221011 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Camellia Place Healthcare Services Llc 24 Sachem Cir Meriden CT 06450-7403 Ph: (203) 715-1319 | Camellia Place Healthcare Services Llc 100 Market Sq Ste 12 Newington CT 06111-2921 Ph: (860) 322-1011 |
| NPI Number | 1447812250 |
|---|---|
| Provider Enumeration Date | 07/01/2019 |
| Last Update Date | 09/06/2019 |
| Medicare PECOS PAC ID | 1557690195 |
|---|---|
| Medicare Enrollment ID | O20190909000339 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447812250 | NPI | - | NPPES |
| Provider Name | Camille Alecia Payne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437433489 PECOS PAC ID: 6406010651 Enrollment ID: I20120619000639 |
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