| Prime Physician Group Inc | |
|
1000 Faulkner Way Greensburg PA 15601-9044 | |
| (724) 853-6847 | |
| Not Available |
| Full Name | Prime Physician Group Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1000 Faulkner Way, Greensburg, Pennsylvania |
| Authorized Official Name and Position | Jude Elias (OWNER/PHYSICIAN) |
| Authorized Official Contact | 7248536847 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Physician Group Inc 1000 Faulkner Way Greensburg PA 15601-9044 Ph: (724) 853-6847 | Prime Physician Group Inc 1000 Faulkner Way Greensburg PA 15601-9044 Ph: (724) 853-6847 |
| NPI Number | 1063128262 |
|---|---|
| Provider Enumeration Date | 01/30/2023 |
| Last Update Date | 01/30/2023 |
| Medicare PECOS PAC ID | 1456716786 |
|---|---|
| Medicare Enrollment ID | O20230420001262 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063128262 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Jude T Elias |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508137050 PECOS PAC ID: 0345468732 Enrollment ID: I20140827000216 |
| Provider Name | Andersen Clervil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558625814 PECOS PAC ID: 9436462132 Enrollment ID: I20150724009970 |
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