| Albany Clinic Llc | |
|
35 Albany Rd Carbondale IL 62903-7646 | |
| (888) 804-4330 | |
| (217) 275-5768 |
| Full Name | Albany Clinic Llc |
|---|---|
| Speciality | Anesthesiology |
| Location | 35 Albany Rd, Carbondale, Illinois |
| Authorized Official Name and Position | Sylvia Garwin (PRACTICE MANAGER) |
| Authorized Official Contact | 8888044330 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Albany Clinic Llc 35 Albany Rd Carbondale IL 62903-7646 Ph: (888) 804-4330 | Albany Clinic Llc 35 Albany Rd Carbondale IL 62903-7646 Ph: (888) 804-4330 |
| NPI Number | 1780310391 |
|---|---|
| Provider Enumeration Date | 07/26/2022 |
| Last Update Date | 09/24/2022 |
| Certification Date | 09/24/2022 |
| Medicare PECOS PAC ID | 5698141646 |
|---|---|
| Medicare Enrollment ID | O20221017003028 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780310391 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 207L00000X | Anesthesiology | (* (Not Available)) | Primary |
| Provider Name | Mark J Garwin |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1326030396 PECOS PAC ID: 0547253775 Enrollment ID: I20041014000441 |
| Provider Name | Simeon J E Grater |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265494850 PECOS PAC ID: 5395831952 Enrollment ID: I20071012000589 |
| Provider Name | Morgan A Gant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275848780 PECOS PAC ID: 7416140751 Enrollment ID: I20101019001563 |
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