| Elijahs Dream Compassionate Care | |
|
134 Creekside Dr Ste 1 Ocoee TN 37361-3653 | |
| (423) 299-9491 | |
| (423) 299-9365 |
| Full Name | Elijahs Dream Compassionate Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 134 Creekside Dr Ste 1, Ocoee, Tennessee |
| Authorized Official Name and Position | Victoria Kinsey (PHYSICIAN) |
| Authorized Official Contact | 4233131865 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elijahs Dream Compassionate Care 2010 Foxfire Rd Ne Cleveland TN 37323-5739 Ph: (423) 313-1865 | Elijahs Dream Compassionate Care 134 Creekside Dr Ste 1 Ocoee TN 37361-3653 Ph: (423) 299-9491 |
| NPI Number | 1407486764 |
|---|---|
| Provider Enumeration Date | 01/24/2020 |
| Last Update Date | 01/24/2020 |
| Medicare PECOS PAC ID | 4284065590 |
|---|---|
| Medicare Enrollment ID | O20200520001432 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407486764 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Victoria L Kinsey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225023799 PECOS PAC ID: 4880583053 Enrollment ID: I20150424000767 |
| Provider Name | Clayton G Marrs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699150185 PECOS PAC ID: 3072805308 Enrollment ID: I20160707001130 |
Bradley Polk Walk In Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 119 White Water Dr, Ocoee, TN 37361 Phone: 423-299-9435 |