| Jubilee Medical Family Practice | |
|
722 Walnut St Reading PA 19601-3520 | |
| (484) 769-7073 | |
| (610) 422-7062 |
| Full Name | Jubilee Medical Family Practice |
|---|---|
| Speciality | Clinic/Center |
| Location | 722 Walnut St, Reading, Pennsylvania |
| Authorized Official Name and Position | Bolaji Owoloja (CEO) |
| Authorized Official Contact | 4847697073 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jubilee Medical Family Practice 15 Bowes Ln Reading PA 19606-9011 Ph: (484) 769-7073 | Jubilee Medical Family Practice 722 Walnut St Reading PA 19601-3520 Ph: (484) 769-7073 |
| NPI Number | 1235567785 |
|---|---|
| Provider Enumeration Date | 10/18/2013 |
| Last Update Date | 10/18/2013 |
| Medicare PECOS PAC ID | 2264661859 |
|---|---|
| Medicare Enrollment ID | O20140130001028 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235567785 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | SP011760 (Pennsylvania) | Primary |
| Provider Name | Bolaji A Owoloja |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205113941 PECOS PAC ID: 9032379516 Enrollment ID: I20120320000631 |
| Provider Name | Tiffany Ferrante |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437750783 PECOS PAC ID: 0345651832 Enrollment ID: I20201207000079 |
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