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127 Route 106 Greenfield Township PA 18407-3526 | |
(570) 278-7500 | |
(570) 278-0707 |
Full Name | |
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Speciality | Clinic/Center |
Location | 127 Route 106, Greenfield Township, Pennsylvania |
Authorized Official Name and Position | Kristen Follert (CEO) |
Authorized Official Contact | 5702785157 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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498 S Main St Ste D Montrose PA 18801-1317 Ph: (570) 278-7500 | 127 Route 106 Greenfield Township PA 18407-3526 Ph: (570) 278-7500 |
NPI Number | 1952801037 |
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Provider Enumeration Date | 02/15/2018 |
Last Update Date | 07/05/2023 |
Medicare PECOS PAC ID | 8921091745 |
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Medicare Enrollment ID | O20180425001620 |
Identifier | Type | State | Issuer |
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1952801037 | NPI | - | NPPES |
1007701310047 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |