Bedford Wellness Center LLC

Organization Active NPI Family Medicine Physician · Bedford, PA

NPI 1649788134 · NPPES record last updated Jan 18, 2018

Key facts

NPI
1649788134
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
OS009365-L (PA)
Legal business name
BEDFORD WELLNESS CENTER LLC
Practice address
342 S Richard St
Bedford, PA 15522-1743
Phone
(814) 623-8414
Fax
(814) 623-6668
NPI assigned
Jan 18, 2018
Organization subpart
No

Authorized official

Name
Tracy L Layton
Title
Biller
Phone
(814) 310-5001

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X OS009365-L PA Yes

Addresses

Primary practice location

342 S Richard St
Bedford, PA 15522-1743

Mailing address

342 S Richard St
Bedford, PA 15522-1743
Phone (814) 623-8414

Other identifiers

IdentifierTypeStateIssuer
0018649730001MedicaidPA

Other names

  • Bedford Wellness Center Other name

Other providers in Bedford, PA

All providers in Bedford, PA · Family Medicine Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.