| Dynamic Healthcare Solutions Pllc | |
|
250 Pierce St Ste 111 Kingston PA 18704-5149 | |
| (570) 772-8879 | |
| Not Available |
| Full Name | Dynamic Healthcare Solutions Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 250 Pierce St Ste 111, Kingston, Pennsylvania |
| Authorized Official Name and Position | Amy E Vanderwall (CO-OWNER) |
| Authorized Official Contact | 5707728879 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dynamic Healthcare Solutions Pllc 60 Oak Ln Montoursville PA 17754-8220 Ph: (570) 772-8879 | Dynamic Healthcare Solutions Pllc 250 Pierce St Ste 111 Kingston PA 18704-5149 Ph: (570) 772-8879 |
| NPI Number | 1487388187 |
|---|---|
| Provider Enumeration Date | 07/11/2022 |
| Last Update Date | 07/28/2022 |
| Medicare PECOS PAC ID | 5597140178 |
|---|---|
| Medicare Enrollment ID | O20220919000286 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487388187 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Amy E Vanderwall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659836914 PECOS PAC ID: 0143558254 Enrollment ID: I20190828001210 |
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