| City Family Clinic Plc | |
|
6401 Douglas Ave Suite 10 Des Moines IA 50322-3350 | |
| (515) 276-8800 | |
| (515) 276-8810 |
| Full Name | City Family Clinic Plc |
|---|---|
| Speciality | Family Medicine |
| Location | 6401 Douglas Ave, Des Moines, Iowa |
| Authorized Official Name and Position | Jason Chinwe Nkem Ekwena (PRESIDENT AND CEO) |
| Authorized Official Contact | 5152768800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| City Family Clinic Plc 6401 Douglas Ave Suite 10 Des Moines IA 50322-3350 Ph: (515) 276-8800 | City Family Clinic Plc 6401 Douglas Ave Suite 10 Des Moines IA 50322-3350 Ph: (515) 276-8800 |
| NPI Number | 1669425625 |
|---|---|
| Provider Enumeration Date | 05/18/2006 |
| Last Update Date | 10/24/2007 |
| Medicare PECOS PAC ID | 9931175510 |
|---|---|
| Medicare Enrollment ID | O20040903001171 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669425625 | NPI | - | NPPES |
| 0443960 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Iowa) | Primary |
| Provider Name | Jason C Ekwena |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396798450 PECOS PAC ID: 2769377324 Enrollment ID: I20040220000989 |
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