Southern Cove Medical Associates | |
2230 Woodbury Pike Suite 2 Loysburg PA 16659-9506 | |
(814) 766-3485 | |
(814) 766-2379 |
Full Name | Southern Cove Medical Associates |
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Speciality | Family Medicine |
Location | 2230 Woodbury Pike, Loysburg, Pennsylvania |
Authorized Official Name and Position | Duane P Dilling (PRESIDENT) |
Authorized Official Contact | 8147663485 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Southern Cove Medical Associates 2230 Woodbury Pike Suite 2 Loysburg PA 16659-9506 Ph: (814) 766-3485 | Southern Cove Medical Associates 2230 Woodbury Pike Suite 2 Loysburg PA 16659-9506 Ph: (814) 766-3485 |
NPI Number | 1194767426 |
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Provider Enumeration Date | 06/12/2006 |
Last Update Date | 08/11/2011 |
Medicare PECOS PAC ID | 7012954845 |
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Medicare Enrollment ID | O20050413000893 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194767426 | NPI | - | NPPES |
14530 | Other | PA | UPMC |
001308770 | Other | PA | HIGHMARK |
001115317 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | OS005846L (Pennsylvania) | Primary |
Provider Name | Duane Paul Dilling |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1114910254 PECOS PAC ID: 4789777111 Enrollment ID: I20100414000330 |
Provider Name | Evalyn S Kennedy |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275059461 PECOS PAC ID: 0143596031 Enrollment ID: I20171020000427 |
Provider Name | Shane M Burkett |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750926010 PECOS PAC ID: 6709210602 Enrollment ID: I20191231002374 |
Provider Name | Brooke Leeann Haubrick |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1376256115 PECOS PAC ID: 7719350032 Enrollment ID: I20230307000318 |
Bhome Medical Associates, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2230 Woodbury Pike Ste 1, Loysburg, PA 16659 Phone: 717-513-6354 |