| Great Health Medical Oh Inc | |
|
1552 N Honeytown Rd Wooster OH 44691-9511 | |
| (718) 470-0288 | |
| Not Available |
| Full Name | Great Health Medical Oh Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1552 N Honeytown Rd, Wooster, Ohio |
| Authorized Official Name and Position | Azlan Tariq (OWNER) |
| Authorized Official Contact | 3127097238 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Health Medical Oh Inc 407 Willoughby Ave Brooklyn NY 11205-4590 Ph: () - | Great Health Medical Oh Inc 1552 N Honeytown Rd Wooster OH 44691-9511 Ph: (718) 470-0288 |
| NPI Number | 1104630912 |
|---|---|
| Provider Enumeration Date | 02/03/2025 |
| Last Update Date | 02/03/2025 |
| Medicare PECOS PAC ID | 1456872597 |
|---|---|
| Medicare Enrollment ID | O20250305003977 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104630912 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Azlan Tariq |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1528291283 PECOS PAC ID: 1355504267 Enrollment ID: I20250307000390 |
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