| Bella Vista Community Health Center | |
|
882 Hunts Point Ave Bronx NY 10474-5402 | |
| (718) 589-2440 | |
| Not Available |
| Full Name | Bella Vista Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 882 Hunts Point Ave, Bronx, New York |
| Authorized Official Name and Position | Samuel Deleon (VP MEDICAL AFFAIRS/CMO) |
| Authorized Official Contact | 7185892440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bella Vista Community Health Center 1065 Southern Blvd Bronx NY 10459-2417 Ph: (718) 589-2440 | Bella Vista Community Health Center 882 Hunts Point Ave Bronx NY 10474-5402 Ph: (718) 589-2440 |
| NPI Number | 1043514615 |
|---|---|
| Provider Enumeration Date | 12/22/2010 |
| Last Update Date | 10/17/2012 |
| Medicare PECOS PAC ID | 3173517281 |
|---|---|
| Medicare Enrollment ID | O20110323000004 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043514615 | NPI | - | NPPES |
| 331016 | Other | NY | FACILITY MEDICARE ID # |
| 02994952 | Other | NY | GROUP MEDICAID ID |
| 03410166 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (New York) | Primary |
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