| Cs Pacs 3 Midwest Llc | |
|
425 Lauricella Ct Englewood OH 45322-0340 | |
| (937) 836-5143 | |
| Not Available |
| Full Name | Cs Pacs 3 Midwest Llc |
|---|---|
| Speciality | Hospitalist |
| Location | 425 Lauricella Ct, Englewood, Ohio |
| Authorized Official Name and Position | Sandra Bakerink (DIRECTOR, PROVIDER ENROLLMENT) |
| Authorized Official Contact | 8655001325 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cs Pacs 3 Midwest Llc 1643 Nw 136th Ave Ste 100 Sunrise FL 33323-2857 Ph: (865) 500-1325 | Cs Pacs 3 Midwest Llc 425 Lauricella Ct Englewood OH 45322-0340 Ph: (937) 836-5143 |
| NPI Number | 1972368785 |
|---|---|
| Provider Enumeration Date | 02/20/2024 |
| Last Update Date | 08/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972368785 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 208M00000X | Hospitalist | (* (Not Available)) | Primary |
Ohio Post-acute Medical Services 1 Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 425 Lauricella Ct, Englewood, OH 45322 Phone: 937-836-5143 | |
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