| |
200 Prushnok Dr Punxsutawney PA 15767-2343 | |
(814) 938-3310 | |
(814) 938-6804 |
Full Name | |
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Speciality | Clinic/Center |
Location | 200 Prushnok Dr, Punxsutawney, Pennsylvania |
Authorized Official Name and Position | Carl A Sizer (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 7243423012 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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63 Pitt St Sharon PA 16146-2102 Ph: (724) 342-3002 | 200 Prushnok Dr Punxsutawney PA 15767-2343 Ph: (814) 938-3310 |
NPI Number | 1790101103 |
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Provider Enumeration Date | 03/10/2014 |
Last Update Date | 07/11/2024 |
Medicare PECOS PAC ID | 9234046228 |
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Medicare Enrollment ID | O20120106000105 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790101103 | NPI | - | NPPES |
1007578460110 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Phillip States, Md, Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 81 Hillcrest Dr, Suite 1300, Punxsutawney, PA 15767 Phone: 814-938-3550 Fax: 814-938-3679 | |
Drayer Physical Therapy Institute Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1464 N Main St Ste 14, Punxsutawney, PA 15767 Phone: 814-618-5234 Fax: 814-618-5571 | |
Pallone Family Healthcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 531 N Main St, Punxsutawney, PA 15767 Phone: 814-249-7583 Fax: 814-249-7584 |