| SS Healthcare PLC | |
|
17913 N 66th Way Phoenix AZ 85054-6730 | |
| (423) 767-8897 | |
| Not Available |
| Full Name | SS Healthcare PLC |
|---|---|
| Speciality | Family Medicine |
| Location | 17913 N 66th Way, Phoenix, Arizona |
| Authorized Official Name and Position | Shiva Kumar Yadav Gosi (OWNER) |
| Authorized Official Contact | 4237678897 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| SS Healthcare PLC 17913 N 66th Way Phoenix AZ 85054-6730 Ph: (423) 767-8897 | SS Healthcare PLC 17913 N 66th Way Phoenix AZ 85054-6730 Ph: (423) 767-8897 |
| NPI Number | 1598508731 |
|---|---|
| Provider Enumeration Date | 06/15/2024 |
| Last Update Date | 06/17/2024 |
| Certification Date | 06/17/2024 |
| Medicare PECOS PAC ID | 1759821598 |
|---|---|
| Medicare Enrollment ID | O20240909000694 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598508731 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
| Provider Name | Shiva Kumar Yadav Gosi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891006532 PECOS PAC ID: 5496980963 Enrollment ID: I20170814000796 |
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