| Renewed Vitality | |
|
560 Van Reed Rd Ste 101 Wyomissing PA 19610-1799 | |
| (484) 516-2937 | |
| (484) 930-0229 |
| Full Name | Renewed Vitality |
|---|---|
| Speciality | General Practice |
| Location | 560 Van Reed Rd Ste 101, Wyomissing, Pennsylvania |
| Authorized Official Name and Position | Rebecca Mcclure (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 4845162937 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renewed Vitality 560 Van Reed Rd Ste 101 Wyomissing PA 19610-1799 Ph: (484) 516-2937 | Renewed Vitality 560 Van Reed Rd Ste 101 Wyomissing PA 19610-1799 Ph: (484) 516-2937 |
| NPI Number | 1336765080 |
|---|---|
| Provider Enumeration Date | 06/18/2020 |
| Last Update Date | 07/27/2023 |
| Medicare PECOS PAC ID | 9133543010 |
|---|---|
| Medicare Enrollment ID | O20200724000829 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336765080 | NPI | - | NPPES |
| Provider Name | John M Movassaghi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457315988 PECOS PAC ID: 0547293193 Enrollment ID: I20050914000474 |
| Provider Name | Rebecca E Mcclure |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326269473 PECOS PAC ID: 0648316778 Enrollment ID: I20091005000059 |
| Provider Name | Debra Hampton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225381536 PECOS PAC ID: 7416199104 Enrollment ID: I20130808000571 |
| Provider Name | Jenna R Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477922847 PECOS PAC ID: 9931409224 Enrollment ID: I20151118000236 |
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