| Agua Vivir | |
|
538 E College Ave State College PA 16801-5518 | |
| (814) 753-4265 | |
| Not Available |
| Full Name | Agua Vivir |
|---|---|
| Speciality | Clinic/Center |
| Location | 538 E College Ave, State College, Pennsylvania |
| Authorized Official Name and Position | Gregory Wolf (OWNER) |
| Authorized Official Contact | 9232650132 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Agua Vivir 248 Varsity Ln State College PA 16803-1845 Ph: (923) 265-0132 | Agua Vivir 538 E College Ave State College PA 16801-5518 Ph: (814) 753-4265 |
| NPI Number | 1659017986 |
|---|---|
| Provider Enumeration Date | 05/10/2022 |
| Last Update Date | 07/06/2022 |
| Medicare PECOS PAC ID | 1557742434 |
|---|---|
| Medicare Enrollment ID | O20220725000277 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659017986 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | David L Blinn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124091871 PECOS PAC ID: 0446158802 Enrollment ID: I20031222000806 |
| Provider Name | Ashley E Wagner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962844985 PECOS PAC ID: 3678716032 Enrollment ID: I20130904000359 |
| Provider Name | Piper Cullen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689237604 PECOS PAC ID: 2860734092 Enrollment ID: I20190508001750 |
State College Family Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2188 Sandy Dr., Suite A, State College, PA 16803 Phone: 814-278-1977 Fax: 814-272-0070 | |
Guillard Internal Medicine Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 905 University Dr, Suite 1, State College, PA 16801 Phone: 814-237-3122 Fax: 814-237-4050 | |
Geisinger Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Scenery Dr, State College, PA 16801 Phone: 814-231-4560 | |
Mount Nittany Center For Wound Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 120 Radnor Rd, State College, PA 16801 Phone: 814-231-7868 Fax: 814-238-4169 | |
Healthy Valley Chiropractic Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 403 S Allen St, State College, PA 16801 Phone: 814-771-0931 | |
Specialists Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1850 E Park Ave, Suite 201, State College, PA 16803 Phone: 814-234-8800 Fax: 814-234-8068 | |
Jeffrey H Baker, Md, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 724 S Atherton St, Suite 200, State College, PA 16801 Phone: 814-867-0717 Fax: 814-867-0464 |