| Vitae Family Care Clinic, L.l.c. | |
|
1355 50th St Suite 100 West Des Moines IA 50266-1617 | |
| (515) 225-3261 | |
| (515) 225-1944 |
| Full Name | Vitae Family Care Clinic, L.l.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 1355 50th St, West Des Moines, Iowa |
| Authorized Official Name and Position | Gregory Carter Mckernan (PHYSICIAN/MANAGER/MEMBER) |
| Authorized Official Contact | 6412033548 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vitae Family Care Clinic, L.l.c. 1355 50th St Suite 100 West Des Moines IA 50266-1617 Ph: (515) 225-3261 | Vitae Family Care Clinic, L.l.c. 1355 50th St Suite 100 West Des Moines IA 50266-1617 Ph: (515) 225-3261 |
| NPI Number | 1386909331 |
|---|---|
| Provider Enumeration Date | 07/05/2012 |
| Last Update Date | 07/06/2012 |
| Medicare PECOS PAC ID | 8628226198 |
|---|---|
| Medicare Enrollment ID | O20120907000634 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386909331 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 02827 (Iowa) | Primary |
| Provider Name | Gregory C Mckernan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558341628 PECOS PAC ID: 8628973906 Enrollment ID: I20031201000143 |
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