| Gifford Street Wellness Center | |
|
34 Gifford St New Bedford MA 02744-2610 | |
| (508) 999-3126 | |
| Not Available |
| Full Name | Gifford Street Wellness Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 34 Gifford St, New Bedford, Massachusetts |
| Authorized Official Name and Position | Brian Phillip Farley (VP & SECRETARY) |
| Authorized Official Contact | 6158616000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gifford Street Wellness Center 6183 Paseo Del Norte Ste 200 Carlsbad CA 92011-1151 Ph: (615) 861-6000 | Gifford Street Wellness Center 34 Gifford St New Bedford MA 02744-2610 Ph: (508) 999-3126 |
| NPI Number | 1891142154 |
|---|---|
| Provider Enumeration Date | 05/17/2016 |
| Last Update Date | 08/11/2023 |
| Medicare PECOS PAC ID | 3274811120 |
|---|---|
| Medicare Enrollment ID | O20161027000167 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891142154 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QM2800X | Clinic/center - Methadone | (* (Not Available)) | Primary |
| Provider Name | Robert E Miller |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1174735666 PECOS PAC ID: 5991776924 Enrollment ID: I20080429000297 |
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