| Country Drive Inn Medical Practice | |
|
10825 Township Road 49 Mount Perry OH 43760-9779 | |
| (740) 683-5165 | |
| Not Available |
| Full Name | Country Drive Inn Medical Practice |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 10825 Township Road 49, Mount Perry, Ohio |
| Authorized Official Name and Position | Arica Reeves (OWNER/PROVIDER) |
| Authorized Official Contact | 7406835165 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Country Drive Inn Medical Practice 10825 Township Road 49 Mount Perry OH 43760-9779 Ph: (740) 683-5165 | Country Drive Inn Medical Practice 10825 Township Road 49 Mount Perry OH 43760-9779 Ph: (740) 683-5165 |
| NPI Number | 1003524430 |
|---|---|
| Provider Enumeration Date | 11/15/2022 |
| Last Update Date | 04/02/2024 |
| Medicare PECOS PAC ID | 8224493168 |
|---|---|
| Medicare Enrollment ID | O20230428002017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003524430 | NPI | - | NPPES |
| 0053044 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
| Provider Name | Arica L Reeves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891081998 PECOS PAC ID: 0244402360 Enrollment ID: I20111015000063 |