| Pembroke Wellness Center Pllc | |
|
48 Glass St Pembroke NH 03275-1506 | |
| (603) 485-7788 | |
| (603) 485-7799 |
| Full Name | Pembroke Wellness Center Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 48 Glass St, Pembroke, New Hampshire |
| Authorized Official Name and Position | Debborah Kaitz Kaitz (RN OFFICE MANAGER) |
| Authorized Official Contact | 6034857788 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pembroke Wellness Center Pllc 48 Glass St Pembroke NH 03275-1506 Ph: (603) 485-7788 | Pembroke Wellness Center Pllc 48 Glass St Pembroke NH 03275-1506 Ph: (603) 485-7788 |
| NPI Number | 1396276655 |
|---|---|
| Provider Enumeration Date | 03/27/2017 |
| Last Update Date | 12/19/2022 |
| Medicare PECOS PAC ID | 6901162841 |
|---|---|
| Medicare Enrollment ID | O20171109002891 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396276655 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Mary M Bacon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245399930 PECOS PAC ID: 8921044520 Enrollment ID: I20050706000065 |
| Provider Name | Jennifer L Mackenzie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598259947 PECOS PAC ID: 7810248457 Enrollment ID: I20210723001161 |
Pembroke Wellness Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 48 Glass St, Pembroke, NH 03275 Phone: 603-485-7788 |