Steinhatchee River Primary Care, Llc | |
101 11th Street Se Steinhatchee FL 32359 | |
(352) 538-1327 | |
Not Available |
Full Name | Steinhatchee River Primary Care, Llc |
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Speciality | Clinic/Center |
Location | 101 11th Street Se, Steinhatchee, Florida |
Authorized Official Name and Position | Kellie Ann White (OWNER) |
Authorized Official Contact | 3525381327 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Steinhatchee River Primary Care, Llc 1400 Ne State Road 47 Trenton FL 32693-5035 Ph: (352) 538-1327 | Steinhatchee River Primary Care, Llc 101 11th Street Se Steinhatchee FL 32359 Ph: (352) 538-1327 |
NPI Number | 1295419877 |
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Provider Enumeration Date | 06/14/2023 |
Last Update Date | 07/28/2023 |
Medicare PECOS PAC ID | 2466813050 |
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Medicare Enrollment ID | O20230728002545 |
Identifier | Type | State | Issuer |
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1295419877 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Kellie Ann White |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073130548 PECOS PAC ID: 9133544323 Enrollment ID: I20200805001342 |
Steinhatchee Family Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1209 1st Avenue South, Steinhatchee, FL 32359 Phone: 385-498-5888 Fax: 352-498-7726 |