| Corporation | |
|
3413 Wilmington Rd New Castle PA 16105-3209 | |
| (724) 656-9005 | |
| (724) 656-9003 |
| Full Name | Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 3413 Wilmington Rd, New Castle, Pennsylvania |
| Authorized Official Name and Position | Carrie Diane Grinnen (CLERICAL MANAGER) |
| Authorized Official Contact | 7246569005 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Corporation 3413 Wilmington Rd New Castle PA 16105-3209 Ph: (724) 656-9005 | Corporation 3413 Wilmington Rd New Castle PA 16105-3209 Ph: (724) 656-9005 |
| NPI Number | 1598898397 |
|---|---|
| Provider Enumeration Date | 03/13/2007 |
| Last Update Date | 07/02/2010 |
| Medicare PECOS PAC ID | 3577555804 |
|---|---|
| Medicare Enrollment ID | O20040330000713 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598898397 | NPI | - | NPPES |
| 0019582470001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Nora Flores-paras |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073507778 PECOS PAC ID: 7517146095 Enrollment ID: I20110131000330 |
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