| Premier Medical Care Llc | |
|
340 Broad St Suite 100 Windsor CT 06095-3030 | |
| (860) 587-7170 | |
| (860) 580-7177 |
| Full Name | Premier Medical Care Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 340 Broad St, Windsor, Connecticut |
| Authorized Official Name and Position | Mohammed A Memon (DIRECTOR) |
| Authorized Official Contact | 8605877170 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Medical Care Llc 340 Broad St Suite 100 Windsor CT 06095-3030 Ph: (860) 587-7170 | Premier Medical Care Llc 340 Broad St Suite 100 Windsor CT 06095-3030 Ph: (860) 587-7170 |
| NPI Number | 1679974521 |
|---|---|
| Provider Enumeration Date | 09/10/2014 |
| Last Update Date | 09/10/2014 |
| Medicare PECOS PAC ID | 4284958257 |
|---|---|
| Medicare Enrollment ID | O20150122000148 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679974521 | NPI | - | NPPES |
| 001425885 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Mohammed A Memon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609826668 PECOS PAC ID: 4880662212 Enrollment ID: I20040922001072 |
| Provider Name | Johnny C Wright |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952455370 PECOS PAC ID: 8426020405 Enrollment ID: I20110823000030 |
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