Black Hills Family Practice Clinic Ps | |
332 S Birch St Mccleary WA 98557-9522 | |
(360) 495-3475 | |
Not Available |
Full Name | Black Hills Family Practice Clinic Ps |
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Speciality | Family Medicine |
Location | 332 S Birch St, Mccleary, Washington |
Authorized Official Name and Position | Edward R Macke (PRESIDENT) |
Authorized Official Contact | 3604953475 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Black Hills Family Practice Clinic Ps Po Box 68 Mccleary WA 98557-0068 Ph: (360) 495-3475 | Black Hills Family Practice Clinic Ps 332 S Birch St Mccleary WA 98557-9522 Ph: (360) 495-3475 |
NPI Number | 1467542399 |
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Provider Enumeration Date | 10/13/2006 |
Last Update Date | 10/13/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1467542399 | NPI | - | NPPES |
15628 | Other | SLI | |
008N | Other | BLUE CROSS | |
75243 | Other | UNIFORM | |
1009515 | Other | COMMUNITY H | |
A002 | Other | TRICARE | |
MA8267 | Other | REGENCE | |
95958 | Other | PACIFIC CARE | |
QMXPR0055448 | Other | MOLINA | |
1252402 | Medicaid | WA | |
8009961 | Other | AETNA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Dba-mccleary Healthcare Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 105 W Simpson Ave, Mccleary, WA 98557 Phone: 360-346-2222 |