| Elderly Care Pc | |
|
225 Humphrey Rd Suite 4 Greensburg PA 15601-4571 | |
| (724) 537-1678 | |
| Not Available |
| Full Name | Elderly Care Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 225 Humphrey Rd, Greensburg, Pennsylvania |
| Authorized Official Name and Position | Joel I Last (PROPRIETOR) |
| Authorized Official Contact | 7245371678 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elderly Care Pc Po Box 292 Latrobe PA 15650-0292 Ph: (724) 537-1678 | Elderly Care Pc 225 Humphrey Rd Suite 4 Greensburg PA 15601-4571 Ph: (724) 537-1678 |
| NPI Number | 1366564981 |
|---|---|
| Provider Enumeration Date | 04/04/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 9234239278 |
|---|---|
| Medicare Enrollment ID | O20070705000434 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366564981 | NPI | - | NPPES |
| 0013014010005 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | MD 040791-L (Pennsylvania) | Primary |
| Provider Name | Joel I Last |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750325031 PECOS PAC ID: 8729986369 Enrollment ID: I20031222000121 |
| Provider Name | Diana L Gummo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700117041 PECOS PAC ID: 0547437923 Enrollment ID: I20120126000089 |
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