| Essential Diabetes And Primary Care Center, Llc | |
|
299 Carew St Ste 300 Springfield MA 01104-2361 | |
| (413) 305-1178 | |
| Not Available |
| Full Name | Essential Diabetes And Primary Care Center, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 299 Carew St Ste 300, Springfield, Massachusetts |
| Authorized Official Name and Position | Tiffany Groover (OWNER) |
| Authorized Official Contact | 4133051178 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Essential Diabetes And Primary Care Center, Llc 225 Corona St Springfield MA 01104-2923 Ph: () - | Essential Diabetes And Primary Care Center, Llc 299 Carew St Ste 300 Springfield MA 01104-2361 Ph: (413) 305-1178 |
| NPI Number | 1023885464 |
|---|---|
| Provider Enumeration Date | 12/06/2023 |
| Last Update Date | 12/06/2023 |
| Medicare PECOS PAC ID | 2769824739 |
|---|---|
| Medicare Enrollment ID | O20240522000675 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023885464 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Tiffany R Groover |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891091310 PECOS PAC ID: 7911123096 Enrollment ID: I20180821001503 |
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