| Bronx Care Dr. Martin Luther King Jr. Health Center | |
|
321 E Tremont Ave Bronx NY 10457 | |
| (718) 901-8600 | |
| (718) 293-1475 |
| Full Name | Bronx Care Dr. Martin Luther King Jr. Health Center |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 321 E Tremont Ave, Bronx, New York |
| Authorized Official Name and Position | Victor G Demarco (SENIOR VP-CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 7189018600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bronx Care Dr. Martin Luther King Jr. Health Center 1276 Fulton Ave Bronx NY 10456-3402 Ph: (718) 901-8600 | Bronx Care Dr. Martin Luther King Jr. Health Center 321 E Tremont Ave Bronx NY 10457 Ph: (718) 901-8600 |
| NPI Number | 1376898908 |
|---|---|
| Provider Enumeration Date | 07/19/2012 |
| Last Update Date | 05/31/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376898908 | NPI | - | NPPES |
| 00244573 | Medicaid | NY | |
| W0437 | Other | NY | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 7000212R (New York) | Primary |
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