| Gallimore Psychiatric Services, Llc | |
|
7901 Schatz Pointe Dr Centerville OH 45459-3824 | |
| (937) 438-9841 | |
| (937) 438-9851 |
| Full Name | Gallimore Psychiatric Services, Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 7901 Schatz Pointe Dr, Centerville, Ohio |
| Authorized Official Name and Position | Tiffani Michelle Gallimore (CERTIFIED NURSE PRACTITIONER) |
| Authorized Official Contact | 9373693234 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gallimore Psychiatric Services, Llc 1256 Ashland Ave Dayton OH 45420-1504 Ph: (937) 369-3234 | Gallimore Psychiatric Services, Llc 7901 Schatz Pointe Dr Centerville OH 45459-3824 Ph: (937) 438-9841 |
| NPI Number | 1295495992 |
|---|---|
| Provider Enumeration Date | 12/21/2021 |
| Last Update Date | 12/21/2021 |
| Certification Date | 12/21/2021 |
| Medicare PECOS PAC ID | 0547645673 |
|---|---|
| Medicare Enrollment ID | O20220909002416 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295495992 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
| Provider Name | Tiffani Michelle Gallimore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639830441 PECOS PAC ID: 0547643843 Enrollment ID: I20220819000579 |
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