Greenwich Pure Medical, Llc | |
15 Valley Dr Greenwich CT 06831-5205 | |
(203) 869-2800 | |
(203) 869-2803 |
Full Name | Greenwich Pure Medical, Llc |
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Speciality | Internal Medicine |
Location | 15 Valley Dr, Greenwich, Connecticut |
Authorized Official Name and Position | Sarah Mildred Gamble (OWNER) |
Authorized Official Contact | 2032782800 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Greenwich Pure Medical, Llc 15 Valley Dr Greenwich CT 06831-5205 Ph: (203) 869-2800 | Greenwich Pure Medical, Llc 15 Valley Dr Greenwich CT 06831-5205 Ph: (203) 869-2800 |
NPI Number | 1871837971 |
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Provider Enumeration Date | 11/15/2012 |
Last Update Date | 06/07/2023 |
Medicare PECOS PAC ID | 1658525365 |
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Medicare Enrollment ID | O20130205000434 |
Identifier | Type | State | Issuer |
---|---|---|---|
1871837971 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 045358 (Connecticut) | Primary |
Provider Name | Sarah M Gamble |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1265649073 PECOS PAC ID: 0749364610 Enrollment ID: I20080303000061 |
Provider Name | Erin Elizabeth Olson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1760729933 PECOS PAC ID: 4486882974 Enrollment ID: I20160209002227 |
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