Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 139 Main St, Eldred, Pennsylvania |
Authorized Official Name and Position | Janie Hilfiger (PRESIDENT) |
Authorized Official Contact | 5707230100 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
1001 E 2nd St Coudersport PA 16915-8161 Ph: () - | 139 Main St Eldred PA 16731 Ph: (814) 225-4241 |
NPI Number | 1164594495 |
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Provider Enumeration Date | 11/14/2006 |
Last Update Date | 11/06/2023 |
Medicare PECOS PAC ID | 3779487475 |
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Medicare Enrollment ID | O20080728000447 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164594495 | NPI | - | NPPES |
100001127-0040 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |