| Shallom Llc | |
|
397 Saly Rd Yardley PA 19067-1979 | |
| (267) 342-1992 | |
| Not Available |
| Full Name | Shallom Llc |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 397 Saly Rd, Yardley, Pennsylvania |
| Authorized Official Name and Position | Toyin Oladele (OWNER/AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 2673421992 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shallom Llc 397 Saly Rd Yardley PA 19067-1979 Ph: (267) 342-1992 | Shallom Llc 397 Saly Rd Yardley PA 19067-1979 Ph: (267) 342-1992 |
| NPI Number | 1467186676 |
|---|---|
| Provider Enumeration Date | 07/13/2022 |
| Last Update Date | 06/20/2023 |
| Certification Date | 06/20/2023 |
| Medicare PECOS PAC ID | 6709248271 |
|---|---|
| Medicare Enrollment ID | O20230815003194 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467186676 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
| Provider Name | Toyin Oladele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760917827 PECOS PAC ID: 2668746207 Enrollment ID: I20230816000072 |
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