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44 Vesper Street Box 430 Beech Creek PA 16822-0430 | |
(570) 962-2922 | |
(570) 962-2944 |
Full Name | |
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Speciality | Psychiatry & Neurology |
Location | 44 Vesper Street, Beech Creek, Pennsylvania |
Authorized Official Name and Position | Steven R Hendricks (PRESIDENT) |
Authorized Official Contact | 5709622922 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 430 44 Vesper Street Beech Creek PA 16822-0430 Ph: (570) 962-2922 | 44 Vesper Street Box 430 Beech Creek PA 16822-0430 Ph: (570) 962-2922 |
NPI Number | 1902976327 |
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Provider Enumeration Date | 11/09/2006 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 1557463460 |
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Medicare Enrollment ID | O20070223000392 |
Identifier | Type | State | Issuer |
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1902976327 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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2084P0800X | Psychiatry & Neurology - Psychiatry | OS-007225-L (Pennsylvania) | Primary |
Provider Name | Steven R Hendricks |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1851426449 PECOS PAC ID: 2365444940 Enrollment ID: I20070212000051 |