| Pea Ridge Family Care Center Inc | |
|
5553 Highway 90 Pace FL 32571-1540 | |
| (850) 995-8811 | |
| (850) 995-8810 |
| Full Name | Pea Ridge Family Care Center Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 5553 Highway 90, Pace, Florida |
| Authorized Official Name and Position | Purushottam K. Garg (OWNER) |
| Authorized Official Contact | 8509958811 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pea Ridge Family Care Center Inc Po Box 2276 Pensacola FL 32513-2276 Ph: (850) 995-8811 | Pea Ridge Family Care Center Inc 5553 Highway 90 Pace FL 32571-1540 Ph: (850) 995-8811 |
| NPI Number | 1306822911 |
|---|---|
| Provider Enumeration Date | 12/16/2005 |
| Last Update Date | 12/12/2011 |
| Medicare PECOS PAC ID | 4284609710 |
|---|---|
| Medicare Enrollment ID | O20040830000103 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306822911 | NPI | - | NPPES |
| 251128200 | Medicaid | FL | |
| 38616 | Other | FL | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Purushottam K Garg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578549085 PECOS PAC ID: 7618942145 Enrollment ID: I20100107000483 |
Alabama Family Healthcare Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5553 Highway 90, Pace, FL 32571 Phone: 850-995-8811 Fax: 850-995-8810 | |
Hwy 90 Pediatrics Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4435 Highway 90, Pace, FL 32571 Phone: 850-436-4630 Fax: 850-436-2095 | |
Baptist Physician Partners Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3874 Highway 90, Pace, FL 32571 Phone: 850-995-4244 Fax: 850-995-9188 | |
Santa Rosa Hma Physician Management Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4225 Woodbine Rd Ste A, Pace, FL 32571 Phone: 850-994-6575 Fax: 850-994-5643 | |
Five Points Family Practice Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5607 Woodbine Rd, Pace, FL 32571 Phone: 850-995-0125 Fax: 850-995-0465 | |
Gastroenterology Associates Of Pensacola Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4485 Woodbine Rd, Pace, FL 32571 Phone: 850-477-2597 Fax: 850-478-7941 | |
American Family Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4713 Highway 90, Pace, FL 32571 Phone: 850-304-0694 Fax: 850-304-0701 |