| Jencare Neighborhood Medical Hull St, Llc | |
|
6550 Hull Street Rd Richmond VA 23224-2636 | |
| (305) 653-1770 | |
| Not Available |
| Full Name | Jencare Neighborhood Medical Hull St, Llc |
|---|---|
| Speciality | Non-Pharmacy Dispensing Site |
| Location | 6550 Hull Street Rd, Richmond, Virginia |
| Authorized Official Name and Position | Mary Chen (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 3058314722 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jencare Neighborhood Medical Hull St, Llc 1395 Nw 167th St Miami Gardens FL 33169-5710 Ph: (305) 628-6117 | Jencare Neighborhood Medical Hull St, Llc 6550 Hull Street Rd Richmond VA 23224-2636 Ph: (305) 653-1770 |
| NPI Number | 1548520422 |
|---|---|
| Provider Enumeration Date | 05/24/2012 |
| Last Update Date | 02/20/2025 |
| Medicare PECOS PAC ID | 8022268564 |
|---|---|
| Medicare Enrollment ID | O20121018000653 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548520422 | NPI | - | NPPES |
| Provider Name | Valerie A Mutchler Fornili |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578657284 PECOS PAC ID: 5395746614 Enrollment ID: I20070129000494 |
| Provider Name | Reman Dhaliwal |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1508006495 PECOS PAC ID: 5294907564 Enrollment ID: I20111010000296 |
| Provider Name | Safa M Mahgoub Osman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215122825 PECOS PAC ID: 7214007129 Enrollment ID: I20160127001634 |
| Provider Name | Maryann Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184167900 PECOS PAC ID: 2961785183 Enrollment ID: I20170214002402 |
| Provider Name | Aaron Stecker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457768939 PECOS PAC ID: 9436463452 Enrollment ID: I20180613000744 |
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