<unavail> in Davenport, IA - Medicare Clinic/Center

is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Davenport, Iowa. The current practice location for is 902 W 4th St, Davenport, Iowa. For appointments, you can reach them via phone at (563) 336-3000. The mailing address for is 500 W River Dr, Davenport, Iowa and phone number is (563) 336-3000.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1124008214. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (563) 336-3000.

Contact Information


	902 W 4th St Davenport IA 52802-3507
	(563) 336-3000
	(563) 336-3125

Map and Direction

Primary Care Clinic Profile

Full Name
Speciality	Clinic/Center
Location	902 W 4th St, Davenport, Iowa
Authorized Official Name and Position	Thomas J Bowman (CEO)
Authorized Official Contact	5633363000
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
500 W River Dr Davenport IA 52801-1014 Ph: (563) 336-3000	902 W 4th St Davenport IA 52802-3507 Ph: (563) 336-3000

NPI Details:

NPI Number	1124008214
Provider Enumeration Date	01/17/2006
Last Update Date	03/25/2024

Medicare PECOS Information:

Medicare PECOS PAC ID	9830008895
Medicare Enrollment ID	O20240516001019

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1124008214	NPI	-	NPPES
113373	Other	IA	UNITED HEALTHCARE
13238	Other	IA	IA BC/BS GROUP#
0080200	Medicaid	IA
8122859	Other	IL	IL BC/BS
=========	Medicaid	IL
CP8565	Other	IA	RAILROAD MEDICARE GROUP #
=========	Other	IA	BILLING TAX ID# FOR CHC

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
261QF0400X	Clinic/center - Federally Qualified Health Center (fqhc)	(* (Not Available))	Primary

Reviews and Comments

Clinic/Center in Davenport, IA

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Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1520 W 53rd St, Davenport, IA 52806 Phone: 563-421-3800 Fax: 563-421-3810

- Medicare Primary Care in Davenport, IA