| Southern Shores Family Wellness | |
|
1606 W 10th St Panama City FL 32401-1908 | |
| (850) 896-7616 | |
| Not Available |
| Full Name | Southern Shores Family Wellness |
|---|---|
| Speciality | Clinic/Center |
| Location | 1606 W 10th St, Panama City, Florida |
| Authorized Official Name and Position | Jodi Buchholz (BILLER) |
| Authorized Official Contact | 8503586290 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Shores Family Wellness 1606 W 10th St Panama City FL 32401-1908 Ph: (850) 896-7616 | Southern Shores Family Wellness 1606 W 10th St Panama City FL 32401-1908 Ph: (850) 896-7616 |
| NPI Number | 1518712728 |
|---|---|
| Provider Enumeration Date | 04/22/2024 |
| Last Update Date | 04/22/2024 |
| Medicare PECOS PAC ID | 0941747851 |
|---|---|
| Medicare Enrollment ID | O20240808002569 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518712728 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Catherine M Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619370616 PECOS PAC ID: 6709109325 Enrollment ID: I20150106000806 |
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