| Carevide | |
|
4311 Wesley St Greenville TX 75401-5639 | |
| (903) 455-5958 | |
| (903) 454-4514 |
| Full Name | Carevide |
|---|---|
| Speciality | Clinic/Center |
| Location | 4311 Wesley St, Greenville, Texas |
| Authorized Official Name and Position | Michelle P Carter (CEO) |
| Authorized Official Contact | 9034555986 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carevide Po Box 1908 Greenville TX 75403-1908 Ph: (903) 455-5986 | Carevide 4311 Wesley St Greenville TX 75401-5639 Ph: (903) 455-5958 |
| NPI Number | 1528041191 |
|---|---|
| Provider Enumeration Date | 11/28/2005 |
| Last Update Date | 06/17/2024 |
| Medicare PECOS PAC ID | 6305735150 |
|---|---|
| Medicare Enrollment ID | O20101117001034 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528041191 | NPI | - | NPPES |
| 112276402 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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