| |
336 Chardonnay Ave Ste A Prosser WA 99350 | |
(509) 786-1576 | |
(509) 786-1574 |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 336 Chardonnay Ave Ste A, Prosser, Washington |
Authorized Official Name and Position | Craig Marks (CEO) |
Authorized Official Contact | 5097862222 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
723 Memorial St Prosser WA 99350-1524 Ph: (509) 786-2222 | 336 Chardonnay Ave Ste A Prosser WA 99350 Ph: (509) 786-1576 |
NPI Number | 1477088391 |
---|---|
Provider Enumeration Date | 04/28/2017 |
Last Update Date | 02/22/2019 |
Medicare PECOS PAC ID | 6709787872 |
---|---|
Medicare Enrollment ID | O20170926001052 |
Identifier | Type | State | Issuer |
---|---|---|---|
1477088391 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Prosser Public Hospital District Of Benton County Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 723 Memorial St, Prosser, WA 99350 Phone: 509-786-2222 | |
Martin Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1309 Scenic Dr, Prosser, WA 99350 Phone: 509-303-9570 | |
Prosser Public Hospital District Of Benton County Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 820 Memorial St Ste 3, Prosser, WA 99350 Phone: 509-786-2222 | |