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1051 S Columbia Ave Connell WA 99326-8702 | |
(509) 234-0866 | |
(509) 488-9939 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1051 S Columbia Ave, Connell, Washington |
Authorized Official Name and Position | Nieves Gomez (CEO) |
Authorized Official Contact | 5094885256 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1515 E Columbia St Othello WA 99344-1846 Ph: (509) 488-5256 | 1051 S Columbia Ave Connell WA 99326-8702 Ph: (509) 234-0866 |
NPI Number | 1841574241 |
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Provider Enumeration Date | 10/04/2011 |
Last Update Date | 05/06/2022 |
Medicare PECOS PAC ID | 4486564309 |
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Medicare Enrollment ID | O20120522001282 |
Identifier | Type | State | Issuer |
---|---|---|---|
1841574241 | NPI | - | NPPES |
0035900 | Other | WA | DLI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (Washington) | Primary |
Ang Medical Clinic Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 661 South Columbia Ave, Connell, WA 99326 Phone: 509-234-0866 Fax: 509-234-0818 | |
Ang Clinic Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 661 South Columbia Ave, Connell, WA 99326 Phone: 509-234-0866 Fax: 509-234-0818 |