| Adult Geriatric Care Group | |
|
12451 W Gentle Rain Rd Peoria AZ 85383-7198 | |
| (857) 400-7436 | |
| (888) 425-0427 |
| Full Name | Adult Geriatric Care Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 12451 W Gentle Rain Rd, Peoria, Arizona |
| Authorized Official Name and Position | Amory Godwin Caringal Grijaldo (NURSE PRACTITIONER/OWNER) |
| Authorized Official Contact | 6026873273 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adult Geriatric Care Group 20403 N Lake Pleasant Rd Ste 117-488 Peoria AZ 85382-9702 Ph: (857) 400-7436 | Adult Geriatric Care Group 12451 W Gentle Rain Rd Peoria AZ 85383-7198 Ph: (857) 400-7436 |
| NPI Number | 1164174272 |
|---|---|
| Provider Enumeration Date | 01/20/2022 |
| Last Update Date | 05/30/2023 |
| Medicare PECOS PAC ID | 0143615351 |
|---|---|
| Medicare Enrollment ID | O20220324000783 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164174272 | NPI | - | NPPES |
| Provider Name | Amory Godwin Grijaldo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487045795 PECOS PAC ID: 0345566402 Enrollment ID: I20150307000237 |
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