| Beacon Primary Care Llc | |
|
3009 Smith Rd Ste 350 Fairlawn OH 44333-2670 | |
| (330) 665-4488 | |
| (330) 665-4489 |
| Full Name | Beacon Primary Care Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3009 Smith Rd Ste 350, Fairlawn, Ohio |
| Authorized Official Name and Position | Jennifer L Wurst (PHYSICIAN/OWNER) |
| Authorized Official Contact | 2162243052 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beacon Primary Care Llc 3009 Smith Rd Ste 350 Fairlawn OH 44333-2670 Ph: (330) 665-4488 | Beacon Primary Care Llc 3009 Smith Rd Ste 350 Fairlawn OH 44333-2670 Ph: (330) 665-4488 |
| NPI Number | 1417772849 |
|---|---|
| Provider Enumeration Date | 11/20/2024 |
| Last Update Date | 11/20/2024 |
| Medicare PECOS PAC ID | 9931629144 |
|---|---|
| Medicare Enrollment ID | O20250218003456 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417772849 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jennifer Wurst |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275510166 PECOS PAC ID: 5092770552 Enrollment ID: I20041123000946 |
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