| Grace Pediatrics Pl | |
|
238 Sw Cullen Ave Fort White FL 32038-3536 | |
| (386) 243-8474 | |
| Not Available |
| Full Name | Grace Pediatrics Pl |
|---|---|
| Speciality | Clinic/Center |
| Location | 238 Sw Cullen Ave, Fort White, Florida |
| Authorized Official Name and Position | Colleen A Thompson (APRN, OWNER) |
| Authorized Official Contact | 3862438474 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Pediatrics Pl 4196 W Us Highway 90 Ste 105 Lake City FL 32055-8834 Ph: (386) 243-8474 | Grace Pediatrics Pl 238 Sw Cullen Ave Fort White FL 32038-3536 Ph: (386) 243-8474 |
| NPI Number | 1326885294 |
|---|---|
| Provider Enumeration Date | 07/09/2024 |
| Last Update Date | 07/09/2024 |
| Medicare PECOS PAC ID | 0547403545 |
|---|---|
| Medicare Enrollment ID | O20240730000554 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326885294 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Columbia Family Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 238 Sw Cullen Ave, Fort White, FL 32038 Phone: 386-497-1397 |