| Trail Medical, Inc | |
|
42 E Rowan Ave Suite A Spokane WA 99207-1212 | |
| (509) 483-3155 | |
| (509) 483-3270 |
| Full Name | Trail Medical, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 42 E Rowan Ave, Spokane, Washington |
| Authorized Official Name and Position | Jeffery A Trail (OWNER) |
| Authorized Official Contact | 5094833155 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trail Medical, Inc 42 E Rowan Ave, Ste A Suite A Spokane WA 99207-1212 Ph: (509) 483-3155 | Trail Medical, Inc 42 E Rowan Ave Suite A Spokane WA 99207-1212 Ph: (509) 483-3155 |
| NPI Number | 1952584419 |
|---|---|
| Provider Enumeration Date | 12/06/2007 |
| Last Update Date | 09/09/2010 |
| Medicare PECOS PAC ID | 7315839891 |
|---|---|
| Medicare Enrollment ID | O20040329000734 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952584419 | NPI | - | NPPES |
| 0033424 | Other | WA | WA LABOR AND INDUSTRIES |
| 1110717 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD00026145 (Washington) | Primary |
| Provider Name | Jeffery A Trail |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578542486 PECOS PAC ID: 1759273238 Enrollment ID: I20101207000468 |
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