| Charles R Grubb Do Pc | |
|
311 Baltimore St Phillipsburg NJ 08865 | |
| (908) 454-8787 | |
| (908) 454-1192 |
| Full Name | Charles R Grubb Do Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 311 Baltimore St, Phillipsburg, New Jersey |
| Authorized Official Name and Position | Maryann Koukias (OFFICE MANAGER) |
| Authorized Official Contact | 9084548787 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Charles R Grubb Do Pc 311 Baltimore St Phillipsburg NJ 08865-1627 Ph: (908) 454-8787 | Charles R Grubb Do Pc 311 Baltimore St Phillipsburg NJ 08865 Ph: (908) 454-8787 |
| NPI Number | 1114004546 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 04/26/2019 |
| Medicare PECOS PAC ID | 9133112147 |
|---|---|
| Medicare Enrollment ID | O20100929001132 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114004546 | NPI | - | NPPES |
| 02292400 | Other | PA | CAPITAL BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 25MB033577 (New Jersey) | Primary |
| Provider Name | Charles Grubb |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1780644831 PECOS PAC ID: 4981729167 Enrollment ID: I20100927001202 |
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