| Mature Resources Foundation | |
|
28944 Frenchville Karthaus Hwy Frenchville PA 16836-8834 | |
| (814) 765-2696 | |
| Not Available |
| Full Name | Mature Resources Foundation |
|---|---|
| Speciality | Family Medicine |
| Location | 28944 Frenchville Karthaus Hwy, Frenchville, Pennsylvania |
| Authorized Official Name and Position | Kathleen Gillespie (CEO) |
| Authorized Official Contact | 8147652696 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mature Resources Foundation Po Box 986500 Boston MA 02298-6500 Ph: () - | Mature Resources Foundation 28944 Frenchville Karthaus Hwy Frenchville PA 16836-8834 Ph: (814) 765-2696 |
| NPI Number | 1447861521 |
|---|---|
| Provider Enumeration Date | 08/12/2020 |
| Last Update Date | 08/12/2020 |
| Medicare PECOS PAC ID | 9537588793 |
|---|---|
| Medicare Enrollment ID | O20201007002979 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447861521 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Baltazar L Corcino |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174574867 PECOS PAC ID: 0547243933 Enrollment ID: I20050824000364 |
| Provider Name | Richard Arthur Johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154379568 PECOS PAC ID: 4082697479 Enrollment ID: I20110415000392 |
| Provider Name | Jessica Ann Ayres |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922341684 PECOS PAC ID: 8921367897 Enrollment ID: I20180123000139 |
| Provider Name | Jamie L Bush |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699289330 PECOS PAC ID: 8729349485 Enrollment ID: I20180221001869 |