| Chung Primary Care Pc | |
|
1400 Willow Ave Frnt Elkins Park PA 19027-3106 | |
| (732) 447-3264 | |
| Not Available |
| Full Name | Chung Primary Care Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1400 Willow Ave Frnt, Elkins Park, Pennsylvania |
| Authorized Official Name and Position | Hack R Chung (PRESIDENT) |
| Authorized Official Contact | 7324473264 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chung Primary Care Pc 1400 Willow Ave Frnt Elkins Park PA 19027-3106 Ph: (732) 447-3264 | Chung Primary Care Pc 1400 Willow Ave Frnt Elkins Park PA 19027-3106 Ph: (732) 447-3264 |
| NPI Number | 1043901606 |
|---|---|
| Provider Enumeration Date | 05/16/2023 |
| Last Update Date | 01/21/2025 |
| Certification Date | 01/21/2025 |
| Medicare PECOS PAC ID | 5991152373 |
|---|---|
| Medicare Enrollment ID | O20231107000160 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043901606 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Hack R Chung |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144394859 PECOS PAC ID: 0749248052 Enrollment ID: I20050103000475 |
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