| Gastrocare Of Southwest Ohio, Llc | |
|
520 Eaton Ave Hamilton OH 45013-2716 | |
| (573) 896-2200 | |
| Not Available |
| Full Name | Gastrocare Of Southwest Ohio, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 520 Eaton Ave, Hamilton, Ohio |
| Authorized Official Name and Position | Dilip Bearelly (OWNER) |
| Authorized Official Contact | 5138962200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gastrocare Of Southwest Ohio, Llc 520 Eaton Ave Hamilton OH 45013-2716 Ph: (573) 896-2200 | Gastrocare Of Southwest Ohio, Llc 520 Eaton Ave Hamilton OH 45013-2716 Ph: (573) 896-2200 |
| NPI Number | 1962044271 |
|---|---|
| Provider Enumeration Date | 10/09/2019 |
| Last Update Date | 04/08/2020 |
| Medicare PECOS PAC ID | 8325477839 |
|---|---|
| Medicare Enrollment ID | O20200404000358 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962044271 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Howard Lee Bernie |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1033158217 PECOS PAC ID: 6002884087 Enrollment ID: I20040922001127 |
| Provider Name | Smith R Bearelly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013164557 PECOS PAC ID: 1052559473 Enrollment ID: I20131223000801 |
| Provider Name | Dilip Bearelly |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1306929435 PECOS PAC ID: 9032211776 Enrollment ID: I20150225002517 |
| Provider Name | Diane M Kallenbach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922605005 PECOS PAC ID: 9032520135 Enrollment ID: I20230208001721 |
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