Lourdes 14th Avenue Medical Group | |
1200 N 14th Ave Pasco WA 99301-4182 | |
(509) 547-7704 | |
Not Available |
Full Name | Lourdes 14th Avenue Medical Group |
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Speciality | Family Medicine |
Location | 1200 N 14th Ave, Pasco, Washington |
Authorized Official Name and Position | John Serle (CEO) |
Authorized Official Contact | 5095432483 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Lourdes 14th Avenue Medical Group 1200 N 14th Ave Pasco WA 99301-4182 Ph: () - | Lourdes 14th Avenue Medical Group 1200 N 14th Ave Pasco WA 99301-4182 Ph: (509) 547-7704 |
NPI Number | 1093006447 |
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Provider Enumeration Date | 04/20/2011 |
Last Update Date | 04/20/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1093006447 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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