Centre Geriatric Care, Llc | |
2134 Sandy Dr Ste 16 State College PA 16803-2292 | |
(814) 272-5805 | |
(814) 272-0110 |
Full Name | Centre Geriatric Care, Llc |
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Speciality | Internal Medicine |
Location | 2134 Sandy Dr Ste 16, State College, Pennsylvania |
Authorized Official Name and Position | Eileen Clarke (PRACTICE MANAGER) |
Authorized Official Contact | 8143596866 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Centre Geriatric Care, Llc 2134 Sandy Dr Ste 16 State College PA 16803-2292 Ph: (814) 272-5805 | Centre Geriatric Care, Llc 2134 Sandy Dr Ste 16 State College PA 16803-2292 Ph: (814) 272-5805 |
NPI Number | 1962166611 |
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Provider Enumeration Date | 10/28/2021 |
Last Update Date | 03/22/2022 |
Medicare PECOS PAC ID | 1355731670 |
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Medicare Enrollment ID | O20211201000094 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962166611 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Dennis A. Shannon |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1770546434 PECOS PAC ID: 6204963341 Enrollment ID: I20100422000272 |
Provider Name | Xenia I Kugler |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1740843531 PECOS PAC ID: 0648501759 Enrollment ID: I20191003001787 |
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