| Jacobus Medical Center, Inc | |
|
55 N Main St Jacobus PA 17407-1248 | |
| (717) 428-1911 | |
| (717) 428-2519 |
| Full Name | Jacobus Medical Center, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 55 N Main St, Jacobus, Pennsylvania |
| Authorized Official Name and Position | Kieren Patrick Knapp (OWNER) |
| Authorized Official Contact | 7174281911 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacobus Medical Center, Inc 55 N Main St Jacobus PA 17407-1248 Ph: (717) 428-1911 | Jacobus Medical Center, Inc 55 N Main St Jacobus PA 17407-1248 Ph: (717) 428-1911 |
| NPI Number | 1124145313 |
|---|---|
| Provider Enumeration Date | 03/23/2007 |
| Last Update Date | 05/17/2010 |
| Medicare PECOS PAC ID | 1557546298 |
|---|---|
| Medicare Enrollment ID | O20110425000201 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124145313 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS004435L (Pennsylvania) | Primary |
| Provider Name | Kieren Patrick Knapp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417911652 PECOS PAC ID: 2466637103 Enrollment ID: I20110425000211 |
Wellspan Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 55 N Main St, Jacobus, PA 17407 Phone: 717-428-1911 Fax: 717-428-2519 |