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49 Ridgmont Dr Ste 1 Ridgway PA 15853-9700 | |
(814) 245-2119 | |
(814) 245-2122 |
Full Name | |
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Speciality | Clinic/Center |
Location | 49 Ridgmont Dr Ste 1, Ridgway, Pennsylvania |
Authorized Official Name and Position | Kristie Bennardi (CEO) |
Authorized Official Contact | 8144861115 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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90 E 2nd St P.o. Box 270 Emporium PA 15834-1302 Ph: (814) 486-1115 | 49 Ridgmont Dr Ste 1 Ridgway PA 15853-9700 Ph: (814) 245-2119 |
NPI Number | 1194260943 |
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Provider Enumeration Date | 01/04/2017 |
Last Update Date | 01/02/2020 |
Medicare PECOS PAC ID | 8022055078 |
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Medicare Enrollment ID | O20170419000793 |
Identifier | Type | State | Issuer |
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1194260943 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Fernan Family Practice Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 200 S. Mill St., Ridgway, PA 15853 Phone: 814-772-0722 Fax: 814-772-6934 |