| Oak Valley Medical & Dental, Pc | |
|
103 New Meadow Run Dr Farmington PA 15437-1391 | |
| (724) 329-8689 | |
| (724) 329-1230 |
| Full Name | Oak Valley Medical & Dental, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 103 New Meadow Run Dr, Farmington, Pennsylvania |
| Authorized Official Name and Position | Verona M Boller (PRESIDENT) |
| Authorized Official Contact | 7243298573 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oak Valley Medical & Dental, Pc 103 New Meadow Run Dr Farmington PA 15437-1391 Ph: (724) 329-8573 | Oak Valley Medical & Dental, Pc 103 New Meadow Run Dr Farmington PA 15437-1391 Ph: (724) 329-8689 |
| NPI Number | 1740267558 |
|---|---|
| Provider Enumeration Date | 12/22/2005 |
| Last Update Date | 10/07/2019 |
| Medicare PECOS PAC ID | 2466426259 |
|---|---|
| Medicare Enrollment ID | O20040826000214 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740267558 | NPI | - | NPPES |
| 024882 | Other | PA | CLIA STATE |
| 39D0925139 | Other | CLIA FEDERAL | |
| 102283015-0002 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Sara Jessie Thomson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1518944321 PECOS PAC ID: 2466427935 Enrollment ID: I20051207000196 |
| Provider Name | Verona M Boller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366734469 PECOS PAC ID: 5395964183 Enrollment ID: I20140909002028 |
| Provider Name | Arthur Darrell Wiser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255759262 PECOS PAC ID: 9537435748 Enrollment ID: I20171016001633 |
| Provider Name | Amelia Lisa Maas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316205420 PECOS PAC ID: 9739497959 Enrollment ID: I20180403000127 |
| Provider Name | Sharon R Wipf |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427376300 PECOS PAC ID: 2860629359 Enrollment ID: I20190926002723 |
Farmington Medical Center Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4176 National Pike, Farmington, PA 15437 Phone: 724-329-4444 Fax: 724-329-0916 |