| Samuel B Rush Md Prof Corporation Pension & Profit Sharing Plan Trust | |
|
684 Medical Center Dr E Clovis CA 93611-6806 | |
| (559) 298-3858 | |
| (559) 298-3830 |
| Full Name | Samuel B Rush Md Prof Corporation Pension & Profit Sharing Plan Trust |
|---|---|
| Speciality | Internal Medicine |
| Location | 684 Medical Center Dr E, Clovis, California |
| Authorized Official Name and Position | Samuel Burton Rush (OWNER) |
| Authorized Official Contact | 5592983850 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Samuel B Rush Md Prof Corporation Pension & Profit Sharing Plan Trust Po Box 28915 Fresno CA 93729-8915 Ph: (559) 258-2800 | Samuel B Rush Md Prof Corporation Pension & Profit Sharing Plan Trust 684 Medical Center Dr E Clovis CA 93611-6806 Ph: (559) 298-3858 |
| NPI Number | 1982926556 |
|---|---|
| Provider Enumeration Date | 02/23/2010 |
| Last Update Date | 06/29/2020 |
| Medicare PECOS PAC ID | 1658402805 |
|---|---|
| Medicare Enrollment ID | O20100701000541 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982926556 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 00G171190 (California) | Primary |
| Provider Name | Samuel B Rush |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780622324 PECOS PAC ID: 9537203294 Enrollment ID: I20100218000228 |
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