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Organization
CENTERWELL SENIOR PRIMARY CARE (MO) PC
Active
Organization
CENTERWELL SENIOR PRIMARY CARE (MO) PC
Active
Parent organization
CENTERWELL SENIOR PRIMARY CARE (MO) PC
Other names
Partners in Primary Care NC PC, CenterWell Senior Primary Care -Grandview, Partners in Primary Care-Grandview
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTERWELL SENIOR PRIMARY CARE (MO) PC
Authorized official
ANGIE MARTINEZ (SENIOR CREDENTIALING PROFESSIONAL)
(407) 447-7120
Entity
Organization
Contact information
Practice address
1513 MAIN ST, GRANDVIEW, MO 64030-2515
(816) 731-1890
(833) 996-1159
Mailing address
6101 BLUE LAGOON DR STE 200, MIAMI, FL 33126-3168
(305) 500-2000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
208D00000X
General Practice Physician
—
NULL
208D00000X
General Practice Physician
—
—
Other
Enumeration date
07/17/2019
Last updated
08/19/2024
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