| Wellness Office Pc | |
|
400 Whitesport Dr Sw Ste 104 Huntsville AL 35801-6429 | |
| (256) 690-5052 | |
| (256) 467-8528 |
| Full Name | Wellness Office Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 400 Whitesport Dr Sw Ste 104, Huntsville, Alabama |
| Authorized Official Name and Position | Quratulain Agha (OWNER) |
| Authorized Official Contact | 2566905052 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellness Office Pc 400 Whitesport Dr Sw Ste 104 Huntsville AL 35801-6429 Ph: (256) 690-5052 | Wellness Office Pc 400 Whitesport Dr Sw Ste 104 Huntsville AL 35801-6429 Ph: (256) 690-5052 |
| NPI Number | 1861905820 |
|---|---|
| Provider Enumeration Date | 11/13/2017 |
| Last Update Date | 10/07/2022 |
| Certification Date | 10/07/2022 |
| Medicare PECOS PAC ID | 5799030961 |
|---|---|
| Medicare Enrollment ID | O20180613000066 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861905820 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Anand Shanker Balachandran |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1003187642 PECOS PAC ID: 4486948973 Enrollment ID: I20160805001323 |
| Provider Name | Quratulain Agha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093155590 PECOS PAC ID: 8123312576 Enrollment ID: I20171130001632 |
| Provider Name | Rachel N Kummer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548788813 PECOS PAC ID: 9234480740 Enrollment ID: I20180922000199 |
| Provider Name | Anand Shanker Balachandran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003187642 PECOS PAC ID: 4486948973 Enrollment ID: I20190910001380 |
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