| Chc-il Homeless Drop In | |
|
2209 3rd Ave Rock Island IL 61201-8806 | |
| (563) 336-3000 | |
| (563) 336-3044 |
| Full Name | Chc-il Homeless Drop In |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 2209 3rd Ave, Rock Island, Illinois |
| Authorized Official Name and Position | Thomas J Bowman (CEO) |
| Authorized Official Contact | 5633363000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chc-il Homeless Drop In 500 W River Dr Davenport IA 52801-1014 Ph: (563) 336-3000 | Chc-il Homeless Drop In 2209 3rd Ave Rock Island IL 61201-8806 Ph: (563) 336-3000 |
| NPI Number | 1093795981 |
|---|---|
| Provider Enumeration Date | 01/18/2006 |
| Last Update Date | 06/15/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093795981 | NPI | - | NPPES |
| 8122859 | Other | IL | ILLINOIS BC/BS GROUP # |
| 91681 | Other | IA | IA BCBS GRP# IN MOLINE |
| 92912 | Other | IA | IA BC/BS GRP# SEEN IN RI |
| 0568980 | Medicaid | IA | |
| 113373 | Other | IL | UNITED HEALTHCARE |
| CP8565 | Other | IA | RAILROAD MEDICARE GROUP # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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