Centreville Health Center is a medicare enrolled dental clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Centreville, Illinois. The current practice location for Centreville Health Center is 6000 Bond Ave, Centreville, Illinois. For appointments, you can reach them via phone at
(618) 332-2740. The mailing address for Centreville Health Center is 2041 Goose Lake Rd, Sauget, Illinois and phone number is (618) 332-0953.
Centreville Health Center is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its
NPI number is 1609813500. This medical practice
accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at
(618) 332-2740.
Dental Care Clinic Profile
| Full Name | Centreville Health Center |
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| Speciality | Clinic/Center |
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| Location | 6000 Bond Ave, Centreville, Illinois |
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| Authorized Official Name and Position | Larry Mcculley (CHIEF EXECUTIVE OFFICER) |
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| Authorized Official Contact | 6183320694 |
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| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Centreville Health Center
2041 Goose Lake Rd
Sauget
IL 62206-2822
Ph: (618) 332-0953 | Centreville Health Center
6000 Bond Ave
Centreville
IL 62207-2328
Ph: (618) 332-2740 |
NPI Details:
| NPI Number | 1609813500 |
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| Provider Enumeration Date | 05/31/2006 |
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| Last Update Date | 05/26/2016 |
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Medicare PECOS Information:
| Medicare PECOS PAC ID | 1456256874 |
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| Medicare Enrollment ID | O20081029000897 |
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Medical Identifiers
Medical identifiers for Centreville Health Center such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1609813500 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 122300000X | Dentist | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207V00000X | Obstetrics & Gynecology | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
| 2080P0202X | Pediatrics - Pediatric Cardiology | (* (Not Available)) | Secondary |
| 2080P0207X | Pediatrics - Pediatric Hematology-oncology | (* (Not Available)) | Secondary |
| 2080P0214X | Pediatrics - Pediatric Pulmonology | (* (Not Available)) | Secondary |
| 2084N0402X | Psychiatry & Neurology - Neurology With Special Qualifications In Child Neurology | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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