| Selfrx Llc | |
|
8 Whittier Pl Apt 19h Boston MA 02114-1410 | |
| (508) 654-8520 | |
| Not Available |
| Full Name | Selfrx Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 8 Whittier Pl Apt 19h, Boston, Massachusetts |
| Authorized Official Name and Position | Martin Hensel (MEMBER) |
| Authorized Official Contact | 6176006500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Selfrx Llc 8 Whittier Pl Apt 19h Boston MA 02114-1410 Ph: (508) 654-8520 | Selfrx Llc 8 Whittier Pl Apt 19h Boston MA 02114-1410 Ph: (508) 654-8520 |
| NPI Number | 1164010765 |
|---|---|
| Provider Enumeration Date | 01/08/2021 |
| Last Update Date | 01/08/2021 |
| Medicare PECOS PAC ID | 3173938651 |
|---|---|
| Medicare Enrollment ID | O20210215001237 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164010765 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Courtney L. Scanlon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932635562 PECOS PAC ID: 7113294109 Enrollment ID: I20201111001968 |
| Provider Name | Colby Uptegraft |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1316385156 PECOS PAC ID: 5395102768 Enrollment ID: I20240930000647 |
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