| Charles Drew Health Center Inc | |
|
5319 N 30th St Ste A Omaha NE 68111-1604 | |
| (402) 457-1216 | |
| (402) 453-2061 |
| Full Name | Charles Drew Health Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5319 N 30th St Ste A, Omaha, Nebraska |
| Authorized Official Name and Position | Andre Stringfellow (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 2915 Grant St Omaha NE 68111-3863 Ph: (402) 810-9762 | Charles Drew Health Center Inc 5319 N 30th St Ste A Omaha NE 68111-1604 Ph: (402) 457-1216 |
| NPI Number | 1154895225 |
|---|---|
| Provider Enumeration Date | 01/11/2019 |
| Last Update Date | 07/11/2024 |
| Medicare PECOS PAC ID | 9830170653 |
|---|---|
| Medicare Enrollment ID | O20190307000230 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154895225 | NPI | - | NPPES |
| 10026276413 | Other | NE | MEDICAID NON FQHC |
| 10026276407 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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