Mt Olive Family Practice Center | |
115 N Poplar St Mount Olive IL 62069-1613 | |
(217) 999-4751 | |
Not Available |
Full Name | Mt Olive Family Practice Center |
---|---|
Speciality | Clinic/Center |
Location | 115 N Poplar St, Mount Olive, Illinois |
Authorized Official Name and Position | Bruce F Weber (DIRECTOR) |
Authorized Official Contact | 2179994751 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Mt Olive Family Practice Center 115 N Poplar St Mount Olive IL 62069-1613 Ph: (217) 999-4751 | Mt Olive Family Practice Center 115 N Poplar St Mount Olive IL 62069-1613 Ph: (217) 999-4751 |
NPI Number | 1881894533 |
---|---|
Provider Enumeration Date | 07/20/2007 |
Last Update Date | 06/09/2023 |
Medicare PECOS PAC ID | 2365350253 |
---|---|
Medicare Enrollment ID | O20030114000003 |
Identifier | Type | State | Issuer |
---|---|---|---|
1881894533 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Mt Olive Family Practice Ctr Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 115 N Poplar St, Mount Olive, IL 62069 Phone: 217-999-4751 Fax: 217-999-2317 |