NPI: 1578182275 · MASTIC, NY 11950 · Health Service Clinic/Center · NPI assigned 04/13/2020
| Authorized Official | JACKSON, MICHELLE (FNP) |
| NPI Enumeration Date | 04/13/2020 |
Other providers sharing the same authorized official: JACKSON, MICHELLE
| Provider | City | State | Total Paid |
|---|---|---|---|
| MOUNTAINEER HOME MEDICAL, LLC | MORGANTOWN | WV | $3.01M |
| WHOLE LIFE HEALTH SUPPORT SERVICES | LAS VEGAS | NV | $1.06M |
| MOUNTAINEER HOME MEDICAL, LLC | CUMBERLAND | MD | $28K |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 45 | $788.37 |