Basic Information
| Provider Information | |||||||||
| NPI: | 1710910278 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GUIDED CARE PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 68 | ||||||||
| Address2: | |||||||||
| City: | OSCEOLA MILLS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 166660068 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8143397101 | ||||||||
| FaxNumber: | 8143396165 | ||||||||
| Practice Location | |||||||||
| Address1: | 330 ENTERPRISE DR STE B | ||||||||
| Address2: | |||||||||
| City: | PHILIPSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 168663174 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8143426636 | ||||||||
| FaxNumber: | 8143425230 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2006 | ||||||||
| LastUpdateDate: | 10/29/2007 | ||||||||
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| AuthorizedOfficialLastName: | BEYER | ||||||||
| AuthorizedOfficialFirstName: | JEANNE | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 8143397101 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0018619350007 | 05 | PA | MEDICAID |