Provider Demographics
NPI:1225750458
Name:PESH MEDICAL CONSULTING LLC
Entity Type:Organization
Organization Name:PESH MEDICAL CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:HILL
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, FNP-BC
Authorized Official - Phone:276-337-0331
Mailing Address - Street 1:6150 CHERRY LN
Mailing Address - Street 2:
Mailing Address - City:WISE
Mailing Address - State:VA
Mailing Address - Zip Code:24293-4464
Mailing Address - Country:US
Mailing Address - Phone:276-337-0331
Mailing Address - Fax:
Practice Address - Street 1:6150 CHERRY LN
Practice Address - Street 2:
Practice Address - City:WISE
Practice Address - State:VA
Practice Address - Zip Code:24293-4464
Practice Address - Country:US
Practice Address - Phone:276-337-0331
Practice Address - Fax:276-796-5707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-14
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service