| Demeter's Garden Pllc | |
|
60 Livingston St Ste 300 Asheville NC 28801-4400 | |
| (412) 608-4116 | |
| Not Available |
| Full Name | Demeter's Garden Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 60 Livingston St Ste 300, Asheville, North Carolina |
| Authorized Official Name and Position | Mary Ellen Gibbons (OWNER) |
| Authorized Official Contact | 4126084116 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Demeter's Garden Pllc 61 Dillingham Rd Asheville NC 28805-1809 Ph: (141) 260-8411 | Demeter's Garden Pllc 60 Livingston St Ste 300 Asheville NC 28801-4400 Ph: (412) 608-4116 |
| NPI Number | 1336914431 |
|---|---|
| Provider Enumeration Date | 11/17/2023 |
| Last Update Date | 11/17/2023 |
| Medicare PECOS PAC ID | 4688023351 |
|---|---|
| Medicare Enrollment ID | O20231207001508 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336914431 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Mary Ellen Gibbons |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1386894913 PECOS PAC ID: 8921162009 Enrollment ID: I20150725012679 |
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