| Prakorb Medical Associate Inc. | |
|
129 Simpson Rd Brownsville PA 15417-9689 | |
| (724) 785-9696 | |
| (724) 785-7225 |
| Full Name | Prakorb Medical Associate Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 129 Simpson Rd, Brownsville, Pennsylvania |
| Authorized Official Name and Position | Prakorb Isariyawongse (OWNER) |
| Authorized Official Contact | 7247859696 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prakorb Medical Associate Inc. 129 Simpson Rd Brownsville PA 15417-9689 Ph: (724) 785-9696 | Prakorb Medical Associate Inc. 129 Simpson Rd Brownsville PA 15417-9689 Ph: (724) 785-9696 |
| NPI Number | 1902127095 |
|---|---|
| Provider Enumeration Date | 06/13/2010 |
| Last Update Date | 06/13/2010 |
| Medicare PECOS PAC ID | 5294865432 |
|---|---|
| Medicare Enrollment ID | O20100614000798 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902127095 | NPI | - | NPPES |
| 000586924 0003 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 033993L (Pennsylvania) | Primary |
| 261QP2300X | Clinic/center - Primary Care | 033993L (Pennsylvania) | Secondary |
| Provider Name | Prakorb Isariyawongse |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1912012022 PECOS PAC ID: 3173653326 Enrollment ID: I20100614000847 |
Centerville Clinics, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 130 California Rd, Brownsville, PA 15417 Phone: 724-938-3554 | |
Centerville Clinics, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 130 California Rd, Brownsville, PA 15417 Phone: 724-938-3554 |