| Jay Ambe Ma LLC | |
|
9316 Paragon Mills Ln Centerville OH 45458-4184 | |
| (937) 304-8551 | |
| Not Available |
| Full Name | Jay Ambe Ma LLC |
|---|---|
| Speciality | General Practice |
| Location | 9316 Paragon Mills Ln, Centerville, Ohio |
| Authorized Official Name and Position | Kamini Patel (DIRECTOR) |
| Authorized Official Contact | 9373048551 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jay Ambe Ma LLC 9316 Paragon Mills Ln Centerville OH 45458-4184 | Jay Ambe Ma LLC 9316 Paragon Mills Ln Centerville OH 45458-4184 Ph: (937) 304-8551 |
| NPI Number | 1326749136 |
|---|---|
| Provider Enumeration Date | 03/17/2023 |
| Last Update Date | 03/17/2023 |
| Certification Date | 03/17/2023 |
| Medicare PECOS PAC ID | 2264898311 |
|---|---|
| Medicare Enrollment ID | O20230516003483 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326749136 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
| Provider Name | Kamini Pranav Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154395689 PECOS PAC ID: 6608894720 Enrollment ID: I20051108000168 |
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