| Security Family Medicine, Llc | |
|
1930 Security Dr York PA 17402-4727 | |
| (717) 741-4641 | |
| (717) 741-9198 |
| Full Name | Security Family Medicine, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1930 Security Dr, York, Pennsylvania |
| Authorized Official Name and Position | Adrienne Johnson (OWNER) |
| Authorized Official Contact | 7177414641 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Security Family Medicine, Llc 1930 Security Dr York PA 17402-4727 Ph: (717) 741-4641 | Security Family Medicine, Llc 1930 Security Dr York PA 17402-4727 Ph: (717) 741-4641 |
| NPI Number | 1285090951 |
|---|---|
| Provider Enumeration Date | 01/11/2016 |
| Last Update Date | 01/11/2016 |
| Medicare PECOS PAC ID | 1850680653 |
|---|---|
| Medicare Enrollment ID | O20160518000914 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285090951 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD066211L (Pennsylvania) | Primary |
| Provider Name | Adrienne R Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164597456 PECOS PAC ID: 6507759800 Enrollment ID: I20040202001021 |
| Provider Name | Condoda D Smith-boyle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376531848 PECOS PAC ID: 1658421193 Enrollment ID: I20090604000204 |
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