| Charles Drew Health Center, Inc At King Science Center Sbhc | |
|
3720 Florence Blvd Omaha NE 68110-1737 | |
| (402) 502-5644 | |
| (402) 502-6436 |
| Full Name | Charles Drew Health Center, Inc At King Science Center Sbhc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3720 Florence Blvd, Omaha, Nebraska |
| Authorized Official Name and Position | Tarsha Denise Jackson (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 4024571215 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Charles Drew Health Center, Inc At King Science Center Sbhc Po Box 30019 2915 Grant Street Omaha NE 68111-3863 Ph: (402) 451-3553 | Charles Drew Health Center, Inc At King Science Center Sbhc 3720 Florence Blvd Omaha NE 68110-1737 Ph: (402) 502-5644 |
| NPI Number | 1639486343 |
|---|---|
| Provider Enumeration Date | 09/02/2010 |
| Last Update Date | 05/10/2021 |
| Certification Date | 05/10/2021 |
| Medicare PECOS PAC ID | 9830170653 |
|---|---|
| Medicare Enrollment ID | O20120731000357 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639486343 | NPI | - | NPPES |
| 100262314-00 | Other | NE | NON-FQHC |
| 100262310-00 | Medicaid | NE |
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