| Greg Purchase Llc | |
|
2221 Peninsula Dr Ste 105 Erie PA 16506-2954 | |
| (814) 969-3031 | |
| Not Available |
| Full Name | Greg Purchase Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2221 Peninsula Dr Ste 105, Erie, Pennsylvania |
| Authorized Official Name and Position | Gregory J Purchase (OWNER) |
| Authorized Official Contact | 8149693031 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greg Purchase Llc 614 Lincoln Ave Erie PA 16505-5014 Ph: (814) 969-3031 | Greg Purchase Llc 2221 Peninsula Dr Ste 105 Erie PA 16506-2954 Ph: (814) 969-3031 |
| NPI Number | 1083113799 |
|---|---|
| Provider Enumeration Date | 02/08/2018 |
| Last Update Date | 06/05/2019 |
| Medicare PECOS PAC ID | 1052676525 |
|---|---|
| Medicare Enrollment ID | O20180604002323 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083113799 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | SW133012 (Pennsylvania) | Primary |
| Provider Name | Gregory John Purchase |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669986956 PECOS PAC ID: 3870858343 Enrollment ID: I20180604002415 |
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