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96 Seaton Ave Unit 8 Greenup KY 41144-1193 | |
| (513) 285-8883 | |
| (502) 792-7289 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 96 Seaton Ave Unit 8, Greenup, Kentucky |
| Authorized Official Name and Position | Tyler Flaugher (PHARMACIST) |
| Authorized Official Contact | 6063166606 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
96 Seaton Ave Unit 8 Greenup KY 41144-1193 Ph: (513) 285-8883 | 96 Seaton Ave Unit 8 Greenup KY 41144-1193 Ph: (513) 285-8883 |
| NPI Number | 1811674658 |
|---|---|
| Provider Enumeration Date | 07/03/2023 |
| Last Update Date | 10/19/2023 |
| Medicare PECOS PAC ID | 9436692548 |
|---|---|
| Medicare Enrollment ID | O20240618000792 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811674658 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Jesus P Querubin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609965375 PECOS PAC ID: 4981517927 Enrollment ID: I20031106000591 |
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