Primary Care Gyn, Pllc | |
4040 Estate La Grande Princess Suite 1 Christiansted VI 00820-5165 | |
(340) 718-7788 | |
(340) 718-9130 |
Full Name | Primary Care Gyn, Pllc |
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Speciality | Advanced Practice Midwife |
Location | 4040 Estate La Grande Princess, Christiansted, Virgin Island |
Authorized Official Name and Position | Arakere B Prasad (OWNER / MANAGER) |
Authorized Official Contact | 3407187788 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Primary Care Gyn, Pllc 4040 Estate La Grande Princess Suite 1 Christiansted VI 00820-5165 Ph: (340) 718-7788 | Primary Care Gyn, Pllc 4040 Estate La Grande Princess Suite 1 Christiansted VI 00820-5165 Ph: (340) 718-7788 |
NPI Number | 1477991495 |
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Provider Enumeration Date | 06/12/2013 |
Last Update Date | 06/12/2013 |
Medicare PECOS PAC ID | 6608003835 |
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Medicare Enrollment ID | O20131216000483 |
Identifier | Type | State | Issuer |
---|---|---|---|
1477991495 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | 621 (Virgin Island) | Secondary |
367A00000X | Advanced Practice Midwife | 11029P (Virgin Island) | Primary |
Provider Name | Shannan Calhoon |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013012038 PECOS PAC ID: 0345364527 Enrollment ID: I20141203001828 |
Provider Name | Carol Roth |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518343128 PECOS PAC ID: 4082037734 Enrollment ID: I20200714000786 |
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