| Core Concierge Primary Care And Wellness Llc | |
|
19330 Lighthouse Plaza Blvd Unit 1 Rehoboth Beach DE 19971-6161 | |
| (302) 585-8555 | |
| Not Available |
| Full Name | Core Concierge Primary Care And Wellness Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 19330 Lighthouse Plaza Blvd Unit 1, Rehoboth Beach, Delaware |
| Authorized Official Name and Position | Bobby A Gulab (OWNER) |
| Authorized Official Contact | 3025858555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Core Concierge Primary Care And Wellness Llc 19330 Lighthouse Plaza Blvd Unit 1 Rehoboth Beach DE 19971-6161 Ph: (302) 585-8555 | Core Concierge Primary Care And Wellness Llc 19330 Lighthouse Plaza Blvd Unit 1 Rehoboth Beach DE 19971-6161 Ph: (302) 585-8555 |
| NPI Number | 1255011227 |
|---|---|
| Provider Enumeration Date | 07/24/2023 |
| Last Update Date | 08/23/2023 |
| Medicare PECOS PAC ID | 8527412899 |
|---|---|
| Medicare Enrollment ID | O20230921000569 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255011227 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Kathryn A Grinnen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710102124 PECOS PAC ID: 9133274624 Enrollment ID: I20090904000452 |
| Provider Name | Bobby A Gulab |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770708182 PECOS PAC ID: 4789837618 Enrollment ID: I20121231000162 |
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