| Tri-county Family Medicine Asso Pc | |
|
1 School St Suite 107 Gowanda NY 14070-1133 | |
| (716) 241-7067 | |
| (716) 241-7197 |
| Full Name | Tri-county Family Medicine Asso Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1 School St, Gowanda, New York |
| Authorized Official Name and Position | Melissa A Pritchard (ADMINISTRATIVE SECRETARY) |
| Authorized Official Contact | 7162417067 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tri-county Family Medicine Asso Pc 1 School St Suite 107 Gowanda NY 14070-1133 Ph: (716) 241-7067 | Tri-county Family Medicine Asso Pc 1 School St Suite 107 Gowanda NY 14070-1133 Ph: (716) 241-7067 |
| NPI Number | 1730268541 |
|---|---|
| Provider Enumeration Date | 11/03/2006 |
| Last Update Date | 04/12/2017 |
| Medicare PECOS PAC ID | 6901852953 |
|---|---|
| Medicare Enrollment ID | O20050323000801 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730268541 | NPI | - | NPPES |
| 01213345 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | James Edward Wild |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437140985 PECOS PAC ID: 2961312392 Enrollment ID: I20050502000325 |
| Provider Name | Dana P Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629069349 PECOS PAC ID: 5890741847 Enrollment ID: I20050502000347 |
Primary Care Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 34 Commercial St, Gowanda, NY 14070 Phone: 716-532-8100 Fax: 716-532-2549 |