Keystone Medical, Pllc | |
77 Calle Portal Suite B260a Sierra Vista AZ 85635-2967 | |
(520) 226-4338 | |
(520) 515-9786 |
Full Name | Keystone Medical, Pllc |
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Speciality | Internal Medicine |
Location | 77 Calle Portal, Sierra Vista, Arizona |
Authorized Official Name and Position | Rebecca Pradhan-nara (SOLE MEMBER) |
Authorized Official Contact | 5202664338 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Keystone Medical, Pllc 77 Calle Portal Suite B260a Sierra Vista AZ 85635-2967 Ph: (520) 226-4338 | Keystone Medical, Pllc 77 Calle Portal Suite B260a Sierra Vista AZ 85635-2967 Ph: (520) 226-4338 |
NPI Number | 1477975647 |
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Provider Enumeration Date | 01/07/2014 |
Last Update Date | 01/20/2016 |
Medicare PECOS PAC ID | 9739312075 |
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Medicare Enrollment ID | O20140512001434 |
Identifier | Type | State | Issuer |
---|---|---|---|
1477975647 | NPI | - | NPPES |
897280 | Medicaid | AZ |
Provider Name | Rebecca Pradhan Nara |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1083602700 PECOS PAC ID: 2365438330 Enrollment ID: I20040423000951 |
Provider Name | Laura L Elliott |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093955023 PECOS PAC ID: 5991994253 Enrollment ID: I20110118001098 |
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