| Specialty Medicine Care, Llc | |
|
2633 Commons Blvd Ste 120 Beavercreek OH 45431-3827 | |
| (937) 429-0607 | |
| (937) 702-9041 |
| Full Name | Specialty Medicine Care, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2633 Commons Blvd Ste 120, Beavercreek, Ohio |
| Authorized Official Name and Position | Troy A Tyner (PRESIDENT) |
| Authorized Official Contact | 9374290607 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Specialty Medicine Care, Llc 2633 Commons Blvd Ste 120 Beavercreek OH 45431-3827 Ph: (937) 429-0607 | Specialty Medicine Care, Llc 2633 Commons Blvd Ste 120 Beavercreek OH 45431-3827 Ph: (937) 429-0607 |
| NPI Number | 1043246630 |
|---|---|
| Provider Enumeration Date | 06/24/2006 |
| Last Update Date | 10/27/2023 |
| Medicare PECOS PAC ID | 4284525635 |
|---|---|
| Medicare Enrollment ID | O20040324000000 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043246630 | NPI | - | NPPES |
| Provider Name | Jenna Mcconnell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306450176 PECOS PAC ID: 2062803117 Enrollment ID: I20211227001293 |
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