| Avon Mediclinic,llc | |
|
1260 Abbe Rd N Elyria OH 44035-1649 | |
| (440) 366-0455 | |
| (440) 281-8839 |
| Full Name | Avon Mediclinic,llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1260 Abbe Rd N, Elyria, Ohio |
| Authorized Official Name and Position | Sanrae J Onyeneke (PRESIDENT) |
| Authorized Official Contact | 4405065674 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Avon Mediclinic,llc 1260 Abbe Rd N Elyria OH 44035-1649 Ph: (440) 366-0455 | Avon Mediclinic,llc 1260 Abbe Rd N Elyria OH 44035-1649 Ph: (440) 366-0455 |
| NPI Number | 1962746958 |
|---|---|
| Provider Enumeration Date | 11/15/2012 |
| Last Update Date | 05/20/2024 |
| Medicare PECOS PAC ID | 3577790898 |
|---|---|
| Medicare Enrollment ID | O20140129001594 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962746958 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (Ohio) | Secondary |
| Provider Name | Chuka D Onyeneke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629104831 PECOS PAC ID: 8921061169 Enrollment ID: I20041116000009 |
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