| Bucktail Medical Center | |
|
1001 Pine St Renovo PA 17764-1618 | |
| (570) 923-1019 | |
| (570) 923-1650 |
| Full Name | Bucktail Medical Center |
|---|---|
| Speciality | Clinic/center - Critical Access Hospital |
| Location | 1001 Pine St, Renovo, Pennsylvania |
| Authorized Official Name and Position | Gary Dailey (ACCOUNTANT) |
| Authorized Official Contact | 5709231000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bucktail Medical Center 1001 Pine St Renovo PA 17764-1618 Ph: (570) 923-1019 | Bucktail Medical Center 1001 Pine St Renovo PA 17764-1618 Ph: (570) 923-1019 |
| NPI Number | 1710907043 |
|---|---|
| Provider Enumeration Date | 07/20/2006 |
| Last Update Date | 03/17/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710907043 | NPI | - | NPPES |
| 1007644390003 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 549601 (Pennsylvania) | Secondary |
| 261QC0050X | Clinic/center - Critical Access Hospital | 549601 (Pennsylvania) | Primary |
Family Practice Of Renovo Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 924 Huron Ave, Renovo, PA 17764 Phone: 570-923-2700 Fax: 570-923-0824 | |
Probst Family Practice, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 924 Huron Ave, Renovo, PA 17764 Phone: 412-655-4362 |