| Green Line Business Group Llc | |
|
1 Innovation Way Newark DE 19711-5442 | |
| (302) 635-0581 | |
| Not Available |
| Full Name | Green Line Business Group Llc |
|---|---|
| Speciality | General Practice |
| Location | 1 Innovation Way, Newark, Delaware |
| Authorized Official Name and Position | Frederik Humphreys (CHIEF TECHNOLOGY OFFICER) |
| Authorized Official Contact | 3026350581 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Green Line Business Group Llc 1 Innovation Way Newark DE 19711-5442 Ph: () - | Green Line Business Group Llc 1 Innovation Way Newark DE 19711-5442 Ph: (302) 635-0581 |
| NPI Number | 1013645324 |
|---|---|
| Provider Enumeration Date | 08/13/2022 |
| Last Update Date | 08/08/2023 |
| Medicare PECOS PAC ID | 7719343003 |
|---|---|
| Medicare Enrollment ID | O20230511000082 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013645324 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Monica A Mehring |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1922012525 PECOS PAC ID: 8022474493 Enrollment ID: I20230510002255 |
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