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4101 John Deere Rd Moline IL 61265-9951 | |
(563) 336-3000 | |
(563) 336-3125 |
Full Name | |
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Speciality | Clinic/Center |
Location | 4101 John Deere Rd, Moline, Illinois |
Authorized Official Name and Position | Thomas Bowman (CEO) |
Authorized Official Contact | 5633363000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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500 W River Dr Davenport IA 52801-1014 Ph: (563) 336-3000 | 4101 John Deere Rd Moline IL 61265-9951 Ph: (563) 336-3000 |
NPI Number | 1467066357 |
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Provider Enumeration Date | 09/08/2020 |
Last Update Date | 02/05/2025 |
Medicare PECOS PAC ID | 9830008895 |
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Medicare Enrollment ID | O20200916000538 |
Identifier | Type | State | Issuer |
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1467066357 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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