| Eac Medical Services, Llc | |
|
704 Brushy Mountain Rd East Stroudsburg PA 18301-9349 | |
| (866) 720-1214 | |
| Not Available |
| Full Name | Eac Medical Services, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 704 Brushy Mountain Rd, East Stroudsburg, Pennsylvania |
| Authorized Official Name and Position | Chukwudi E Ogbolu (OWNER) |
| Authorized Official Contact | 8667201214 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eac Medical Services, Llc 704 Brushy Mountain Rd East Stroudsburg PA 18301-9349 Ph: () - | Eac Medical Services, Llc 704 Brushy Mountain Rd East Stroudsburg PA 18301-9349 Ph: (866) 720-1214 |
| NPI Number | 1417338054 |
|---|---|
| Provider Enumeration Date | 06/09/2015 |
| Last Update Date | 06/09/2015 |
| Medicare PECOS PAC ID | 3274848700 |
|---|---|
| Medicare Enrollment ID | O20150813009482 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417338054 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD421052 (Pennsylvania) | Primary |
| Provider Name | Chukwudi Emmanuel Ogbolu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629038468 PECOS PAC ID: 2163460304 Enrollment ID: I20050419001108 |
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