| Charles Drew Health Center Inc At St. Richards | |
|
4320 Fort St Omaha NE 68111-1849 | |
| (402) 451-3553 | |
| (402) 453-1970 |
| Full Name | Charles Drew Health Center Inc At St. Richards |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 4320 Fort St, Omaha, Nebraska |
| Authorized Official Name and Position | Tarsha Denise Jackson (CFO) |
| Authorized Official Contact | 4024571215 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Charles Drew Health Center Inc At St. Richards Po Box 30019 Omaha NE 68103-1119 Ph: (402) 451-3553 | Charles Drew Health Center Inc At St. Richards 4320 Fort St Omaha NE 68111-1849 Ph: (402) 451-3553 |
| NPI Number | 1649653551 |
|---|---|
| Provider Enumeration Date | 07/09/2015 |
| Last Update Date | 03/30/2021 |
| Certification Date | 03/30/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649653551 | NPI | - | NPPES |
| 10026276401 | Medicaid | NE |
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