| Bps Benton Family Practice | |
|
4469 Red Rock Rd Benton PA 17814-7606 | |
| (570) 925-6424 | |
| Not Available |
| Full Name | Bps Benton Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 4469 Red Rock Rd, Benton, Pennsylvania |
| Authorized Official Name and Position | Regis Cabonor (CEO) |
| Authorized Official Contact | 5703872100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bps Benton Family Practice Po Box 919 Bloomsburg PA 17815-0919 Ph: (570) 387-2100 | Bps Benton Family Practice 4469 Red Rock Rd Benton PA 17814-7606 Ph: (570) 925-6424 |
| NPI Number | 1285967208 |
|---|---|
| Provider Enumeration Date | 09/09/2009 |
| Last Update Date | 09/09/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285967208 | NPI | - | NPPES |
| 001811559 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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Vine Pharmacy Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4375 Red Rock Rd, Benton, PA 17814 Phone: 570-925-2500 Fax: 570-925-5771 | |
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