| Jordan Healthcare Center, Llc | |
|
800 College Hwy Southwick MA 01077-9690 | |
| (413) 695-6774 | |
| Not Available |
| Full Name | Jordan Healthcare Center, Llc |
|---|---|
| Speciality | General Practice |
| Location | 800 College Hwy, Southwick, Massachusetts |
| Authorized Official Name and Position | Jennifer L Jordan (MEMBER/OWNER) |
| Authorized Official Contact | 4136956774 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jordan Healthcare Center, Llc 800 College Hwy Southwick MA 01077-9690 Ph: () - | Jordan Healthcare Center, Llc 800 College Hwy Southwick MA 01077-9690 Ph: (413) 695-6774 |
| NPI Number | 1215673702 |
|---|---|
| Provider Enumeration Date | 05/09/2022 |
| Last Update Date | 05/09/2022 |
| Medicare PECOS PAC ID | 5193109197 |
|---|---|
| Medicare Enrollment ID | O20220824003458 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215673702 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 261QH0100X | Clinic/center - Health Service | (* (Not Available)) | Secondary |
| Provider Name | Jennifer L Jordan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891185674 PECOS PAC ID: 7416363296 Enrollment ID: I20210302001618 |
| Provider Name | Jessie M Fisher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306577663 PECOS PAC ID: 3779956669 Enrollment ID: I20230223001083 |