| Community Health Center Of Pinellas Inc. | |
|
701 16th St S Bldg 7 St Petersburg FL 33705-2135 | |
| (727) 824-8181 | |
| (727) 824-8153 |
| Full Name | Community Health Center Of Pinellas Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 701 16th St S Bldg 7, St Petersburg, Florida |
| Authorized Official Name and Position | Edward Kucher (CHIEF REGULATORY OFFICER) |
| Authorized Official Contact | 7278248100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Health Center Of Pinellas Inc. Po Box 10549 St Petersburg FL 33733-0549 Ph: (727) 824-8181 | Community Health Center Of Pinellas Inc. 701 16th St S Bldg 7 St Petersburg FL 33705-2135 Ph: (727) 824-8181 |
| NPI Number | 1013669878 |
|---|---|
| Provider Enumeration Date | 01/24/2022 |
| Last Update Date | 10/17/2024 |
| Medicare PECOS PAC ID | 8527961028 |
|---|---|
| Medicare Enrollment ID | O20220802002281 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013669878 | NPI | - | NPPES |
| 029565535 | Medicaid | FL | |
| 029565534 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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