| Open Arms Internal Medicine & Pediatrics, Pc | |
|
3155 Lycoming Creek Rd Williamsport PA 17701-1032 | |
| (570) 244-1877 | |
| Not Available |
| Full Name | Open Arms Internal Medicine & Pediatrics, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3155 Lycoming Creek Rd, Williamsport, Pennsylvania |
| Authorized Official Name and Position | Russell Lewis Gombosi (OWNER) |
| Authorized Official Contact | 5702441877 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Open Arms Internal Medicine & Pediatrics, Pc 5271 State Route 973 E Cogan Station PA 17728-8500 Ph: (570) 244-1877 | Open Arms Internal Medicine & Pediatrics, Pc 3155 Lycoming Creek Rd Williamsport PA 17701-1032 Ph: (570) 244-1877 |
| NPI Number | 1154834927 |
|---|---|
| Provider Enumeration Date | 11/14/2017 |
| Last Update Date | 11/14/2017 |
| Medicare PECOS PAC ID | 4284995663 |
|---|---|
| Medicare Enrollment ID | O20180227001733 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154834927 | NPI | - | NPPES |
| 1528078433 | Other | PA | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | MD043621L (Pennsylvania) | Primary |
| Provider Name | Russell L Gombosi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528078433 PECOS PAC ID: 3476541814 Enrollment ID: I20040504000814 |
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