| Genesis Eldercare Physician Services LLC | |
|
464 Main St Heritage Hall East Agawam MA 01001 | |
| (413) 786-8000 | |
| (413) 789-1099 |
| Full Name | Genesis Eldercare Physician Services LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 464 Main St, Agawam, Massachusetts |
| Authorized Official Name and Position | Eric Shapiro (VP, CONTROLLER) |
| Authorized Official Contact | 4108327790 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Eldercare Physician Services LLC Po Box 62946 Baltimore MD 21264-2946 Ph: (410) 494-7607 | Genesis Eldercare Physician Services LLC 464 Main St Heritage Hall East Agawam MA 01001 Ph: (413) 786-8000 |
| NPI Number | 1104819259 |
|---|---|
| Provider Enumeration Date | 08/24/2005 |
| Last Update Date | 08/05/2019 |
| Medicare PECOS PAC ID | 9830002534 |
|---|---|
| Medicare Enrollment ID | O20040824000702 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104819259 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 75866 (Massachusetts) | Primary |
| Provider Name | Lynn M Mccolgan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1144204363 PECOS PAC ID: 0345291803 Enrollment ID: I20050202000650 |
| Provider Name | Martha W. Mohr |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1033543137 PECOS PAC ID: 7315170032 Enrollment ID: I20140505001396 |
| Provider Name | Michelle L Turner |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1760907059 PECOS PAC ID: 5698031664 Enrollment ID: I20171107002086 |
Am Medical PC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 723 Main St, Agawam, MA 01001 Phone: 413-374-0031 Fax: 413-384-2526 |
Internal Medicine PC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 377 Walnut Street Extension, Agawam, MA 01001 Phone: 413-786-7217 Fax: 413-786-7219 |
Geriatric Primary Care PC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 723 Main St, Agawam, MA 01001 Phone: 413-374-0031 Fax: 413-384-2526 |