| Berea Clinic Of Internal Medicine, Psc | |
|
1036 Ace Dr Berea KY 40403-1327 | |
| (859) 986-3124 | |
| (859) 986-9398 |
| Full Name | Berea Clinic Of Internal Medicine, Psc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1036 Ace Dr, Berea, Kentucky |
| Authorized Official Name and Position | George L. Schloemer (OWNER) |
| Authorized Official Contact | 8599863124 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Berea Clinic Of Internal Medicine, Psc 1036 Ace Dr Berea KY 40403-1327 Ph: (859) 986-3124 | Berea Clinic Of Internal Medicine, Psc 1036 Ace Dr Berea KY 40403-1327 Ph: (859) 986-3124 |
| NPI Number | 1700819802 |
|---|---|
| Provider Enumeration Date | 07/09/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 7113975343 |
|---|---|
| Medicare Enrollment ID | O20050105000030 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700819802 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Patrick Anthony Kelleher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952345522 PECOS PAC ID: 9931185006 Enrollment ID: I20040629000070 |
| Provider Name | George Schloemer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598705980 PECOS PAC ID: 2769661875 Enrollment ID: I20120222000307 |
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