Gloucester Mathews Care Clinic | |
6031 Industrial Dr Gloucester VA 23061-3767 | |
(804) 210-1368 | |
(804) 210-1369 |
Full Name | Gloucester Mathews Care Clinic |
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Speciality | Clinic/Center |
Location | 6031 Industrial Dr, Gloucester, Virginia |
Authorized Official Name and Position | Arlene Armentor (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 8042101368 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Gloucester Mathews Care Clinic Po Box 684 Gloucester VA 23061-0684 Ph: (804) 210-1368 | Gloucester Mathews Care Clinic 6031 Industrial Dr Gloucester VA 23061-3767 Ph: (804) 210-1368 |
NPI Number | 1184051575 |
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Provider Enumeration Date | 10/01/2013 |
Last Update Date | 01/28/2020 |
Medicare PECOS PAC ID | 2961731955 |
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Medicare Enrollment ID | O20190917002891 |
Identifier | Type | State | Issuer |
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1184051575 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Wayne J Reynolds |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1851366173 PECOS PAC ID: 6800789405 Enrollment ID: I20041120000170 |
Provider Name | Wendell Turner Poulsen |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1457326811 PECOS PAC ID: 6608816814 Enrollment ID: I20050506000568 |
Provider Name | Robert T Davis |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1285716712 PECOS PAC ID: 1254331168 Enrollment ID: I20070314000084 |
Provider Name | Carol-jo Osinski |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538452164 PECOS PAC ID: 7012247794 Enrollment ID: I20190923002534 |
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