| Tri-county Family Medicine Asso Pc | |
| 
					1 School St Suite 107 Gowanda NY 14070-1133  | |
| (716) 241-7067 | |
| (716) 241-7197 | 
| Full Name | Tri-county Family Medicine Asso Pc | 
|---|---|
| Speciality | Family Medicine | 
| Location | 1 School St, Gowanda, New York | 
| Authorized Official Name and Position | Melissa A Pritchard (ADMINISTRATIVE SECRETARY) | 
| Authorized Official Contact | 7162417067 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Tri-county Family Medicine Asso Pc 1 School St Suite 107 Gowanda NY 14070-1133 Ph: (716) 241-7067  | Tri-county Family Medicine Asso Pc 1 School St Suite 107 Gowanda NY 14070-1133 Ph: (716) 241-7067  | 
| NPI Number | 1730268541 | 
|---|---|
| Provider Enumeration Date | 11/03/2006 | 
| Last Update Date | 04/12/2017 | 
| Medicare PECOS PAC ID | 6901852953 | 
|---|---|
| Medicare Enrollment ID | O20050323000801 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1730268541 | NPI | - | NPPES | 
| 01213345 | Medicaid | NY | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary | 
| Provider Name | James Edward Wild | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1437140985 PECOS PAC ID: 2961312392 Enrollment ID: I20050502000325  | 
| Provider Name | Dana P Anderson | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1629069349 PECOS PAC ID: 5890741847 Enrollment ID: I20050502000347  | 
Brooks - Tlc Hospital System Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 34 Commercial St, Gowanda, NY 14070 Phone: 716-532-8100 Fax: 716-532-2549  |