| New Life Wellness Llc | |
|
256 E Hurlburt Ave Ste 117 Hermiston OR 97838-2443 | |
| (541) 303-3558 | |
| (509) 593-4644 |
| Full Name | New Life Wellness Llc |
|---|---|
| Speciality | Preventive Medicine |
| Location | 256 E Hurlburt Ave Ste 117, Hermiston, Oregon |
| Authorized Official Name and Position | Randall Kelly (PHYSICIAN ASSISTANT, OWNER) |
| Authorized Official Contact | 2064188222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Life Wellness Llc 5426 Road 68 Ste D253 Pasco WA 99301-5268 Ph: (541) 303-3558 | New Life Wellness Llc 256 E Hurlburt Ave Ste 117 Hermiston OR 97838-2443 Ph: (541) 303-3558 |
| NPI Number | 1508463639 |
|---|---|
| Provider Enumeration Date | 10/01/2020 |
| Last Update Date | 07/29/2024 |
| Certification Date | 07/29/2024 |
| Medicare PECOS PAC ID | 7719358886 |
|---|---|
| Medicare Enrollment ID | O20230127001731 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508463639 | NPI | - | NPPES |
| 500698482 | Medicaid | OR |
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