| Family Wellness Center Gcs Inc | |
|
3189 Highway 17 Green Cove Springs FL 32043-9371 | |
| (904) 621-0247 | |
| Not Available |
| Full Name | Family Wellness Center Gcs Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 3189 Highway 17, Green Cove Springs, Florida |
| Authorized Official Name and Position | Randall Scott (OWNER) |
| Authorized Official Contact | 9046210247 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Wellness Center Gcs Inc 3189 Highway 17 Green Cove Springs FL 32043-9371 Ph: (904) 621-0247 | Family Wellness Center Gcs Inc 3189 Highway 17 Green Cove Springs FL 32043-9371 Ph: (904) 621-0247 |
| NPI Number | 1861954653 |
|---|---|
| Provider Enumeration Date | 04/02/2019 |
| Last Update Date | 09/21/2022 |
| Medicare PECOS PAC ID | 3375885890 |
|---|---|
| Medicare Enrollment ID | O20190612001113 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861954653 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Randall Scott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619138658 PECOS PAC ID: 6406034586 Enrollment ID: I20110620000124 |
| Provider Name | Brandi A Epperson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154757151 PECOS PAC ID: 5799078432 Enrollment ID: I20210924003002 |
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