| Priority Care Provider, Llc | |
|
1000 Gum Pl Apt A Huntingdon Valley PA 19006-1716 | |
| (267) 254-4553 | |
| (215) 893-5231 |
| Full Name | Priority Care Provider, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1000 Gum Pl Apt A, Huntingdon Valley, Pennsylvania |
| Authorized Official Name and Position | Mark Nimchuk (CEO) |
| Authorized Official Contact | 2672544553 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Priority Care Provider, Llc 425 Lawrence Rd Huntingdon Valley PA 19006-2334 Ph: (267) 254-4553 | Priority Care Provider, Llc 1000 Gum Pl Apt A Huntingdon Valley PA 19006-1716 Ph: (267) 254-4553 |
| NPI Number | 1629566203 |
|---|---|
| Provider Enumeration Date | 04/29/2018 |
| Last Update Date | 04/29/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629566203 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | CER-00125254 (Pennsylvania) | Primary |
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