| Avon Family Health, Llc | |
|
30 W Avon Rd Suite D Avon CT 06001-3678 | |
| (860) 675-6595 | |
| (860) 673-6721 |
| Full Name | Avon Family Health, Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 30 W Avon Rd, Avon, Connecticut |
| Authorized Official Name and Position | Mary Elizabeth Leahy (MEMBER) |
| Authorized Official Contact | 8606756595 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Avon Family Health, Llc 30 W Avon Rd Suite D Avon CT 06001-3678 Ph: (860) 675-6595 | Avon Family Health, Llc 30 W Avon Rd Suite D Avon CT 06001-3678 Ph: (860) 675-6595 |
| NPI Number | 1497115380 |
|---|---|
| Provider Enumeration Date | 03/04/2016 |
| Last Update Date | 07/20/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497115380 | NPI | - | NPPES |
| 004238003 | Medicaid | CT | |
| 11243173 | Other | CAQH | |
| 1669496113 | Other | TRICARE | |
| 11000341 | Other | CT | GROUP MEDICAID |
| D400060973 | Other | MEDICARE PTAN | |
| 7327000 | Other | CIGNA | |
| 637238 | Other | WELLCARE | |
| P4395587 | Other | OXFORD | |
| 1100341 | Other | GROUP MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (Connecticut) | Primary |
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