| Main Street Medical Center Inc | |
|
24 South Main Street Shenandoah PA 17976 | |
| (570) 462-1033 | |
| (570) 462-1171 |
| Full Name | Main Street Medical Center Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 24 South Main Street, Shenandoah, Pennsylvania |
| Authorized Official Name and Position | Adolph Michael Wychulis (OWNER) |
| Authorized Official Contact | 5704621033 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Street Medical Center Inc 24 South Main Street Shenandoah PA 17976 Ph: (570) 462-1033 | Main Street Medical Center Inc 24 South Main Street Shenandoah PA 17976 Ph: (570) 462-1033 |
| NPI Number | 1063561041 |
|---|---|
| Provider Enumeration Date | 01/09/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063561041 | NPI | - | NPPES |
| 0019487500001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD418365 (Pennsylvania) | Primary |
James W. T. Hu Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 239 W. Center St, Shenandoah, PA 17976 Phone: 570-462-3542 Fax: 570-462-3542 | |
Shenandoah Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 624 W Centre St, Shenandoah, PA 17976 Phone: 570-671-0300 Fax: 570-671-0305 | |
Anthony J Saraceni, Do Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 25 N Main St, Shenandoah, PA 17976 Phone: 570-462-2783 Fax: 570-462-2783 |