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2512 Hurst Dr Mattoon IL 61938-9200 | |
(217) 258-5900 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 2512 Hurst Dr, Mattoon, Illinois |
Authorized Official Name and Position | Harry Brockus (CEO) |
Authorized Official Contact | 2172838540 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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611 W Park St Urbana IL 61801-2500 Ph: (217) 383-3311 | 2512 Hurst Dr Mattoon IL 61938-9200 Ph: (217) 258-5900 |
NPI Number | 1750785986 |
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Provider Enumeration Date | 10/17/2014 |
Last Update Date | 10/17/2014 |
Medicare PECOS PAC ID | 3577456037 |
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Medicare Enrollment ID | O20141110000785 |
Identifier | Type | State | Issuer |
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1750785986 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (Illinois) | Primary |
Bella Family Health And Wellness, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10555 E County Road 800n, Mattoon, IL 61938 Phone: 217-235-4227 Fax: 217-235-4274 | |