<unavail> in Wallingford, CT - Medicare Clinic/Center

is a medicare enrolled primary clinic (Clinic/center) in Wallingford, Connecticut. The current practice location for is 300 Church St, Wallingford, Connecticut. For appointments, you can reach them via phone at (860) 994-7339. The mailing address for is 300 Church St Ste 103, Wallingford, Connecticut and phone number is (860) 994-7339.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1083317390. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (860) 994-7339.

Contact Information


	300 Church St Wallingford CT 06492-2253
	(860) 994-7339
	Not Available

Map and Direction

Primary Care Clinic Profile

Full Name
Speciality	Clinic/Center
Location	300 Church St, Wallingford, Connecticut
Authorized Official Name and Position	Authurine Hannam-davis (FAMILY NURSE PRACTITIONER)
Authorized Official Contact	8609947339
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
300 Church St Ste 103 Wallingford CT 06492-2253 Ph: (860) 994-7339	300 Church St Wallingford CT 06492-2253 Ph: (860) 994-7339

NPI Details:

NPI Number	1083317390
Provider Enumeration Date	03/24/2023
Last Update Date	10/20/2024

Medicare PECOS Information:

Medicare PECOS PAC ID	9133652274
Medicare Enrollment ID	O20241029001505

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1083317390	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
261Q00000X	Clinic/center	(* (Not Available))	Primary
363LF0000X	Nurse Practitioner - Family	(* (Not Available))	Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:

Provider Name	Authurine W Hannam-davis
Provider Type	Practitioner - Nurse Practitioner
Provider Identifiers	NPI Number: 1891241873 PECOS PAC ID: 8022378884 Enrollment ID: I20180216000514

Reviews and Comments

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- Medicare Primary Care in Wallingford, CT