Bullhead Primary Care, Llc | |
1355 Ramar Rd Ste 11a Bullhead City AZ 86442-7100 | |
(928) 704-9217 | |
Not Available |
Full Name | Bullhead Primary Care, Llc |
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Speciality | General Practice |
Location | 1355 Ramar Rd Ste 11a, Bullhead City, Arizona |
Authorized Official Name and Position | Shakti Soni (MANAGER) |
Authorized Official Contact | 9287049217 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Bullhead Primary Care, Llc 1355 Ramar Rd Ste 11a Bullhead City AZ 86442-7100 Ph: (928) 704-9217 | Bullhead Primary Care, Llc 1355 Ramar Rd Ste 11a Bullhead City AZ 86442-7100 Ph: (928) 704-9217 |
NPI Number | 1346944022 |
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Provider Enumeration Date | 03/28/2023 |
Last Update Date | 03/29/2023 |
Medicare PECOS PAC ID | 4981048840 |
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Medicare Enrollment ID | O20240219002484 |
Identifier | Type | State | Issuer |
---|---|---|---|
1346944022 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Kerstin Mcelvain |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1508320706 PECOS PAC ID: 1355504663 Enrollment ID: I20190306000921 |
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