| Community Health Center Of Fort Dodge, Inc. | |
|
306 W Broadway St Eagle Grove IA 50533-1712 | |
| (515) 576-6500 | |
| (515) 576-1951 |
| Full Name | Community Health Center Of Fort Dodge, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 306 W Broadway St, Eagle Grove, Iowa |
| Authorized Official Name and Position | Renae Irene Elizabeth Kruckenberg (CEO) |
| Authorized Official Contact | 5155766500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Health Center Of Fort Dodge, Inc. 126 N 10th St Fort Dodge IA 50501-3915 Ph: (515) 576-6500 | Community Health Center Of Fort Dodge, Inc. 306 W Broadway St Eagle Grove IA 50533-1712 Ph: (515) 576-6500 |
| NPI Number | 1801596325 |
|---|---|
| Provider Enumeration Date | 03/03/2023 |
| Last Update Date | 03/03/2023 |
| Medicare PECOS PAC ID | 1557378627 |
|---|---|
| Medicare Enrollment ID | O20230612000391 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801596325 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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