Coulee Medical Center | |
411 Fortuyn Rd Grand Coulee WA 99133-8718 | |
(509) 633-6375 | |
(509) 633-3644 |
Full Name | Coulee Medical Center |
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Speciality | Clinic/Center |
Location | 411 Fortuyn Rd, Grand Coulee, Washington |
Authorized Official Name and Position | Jean Clark (CREDENTIALING COORDINATOR) |
Authorized Official Contact | 5096336345 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Coulee Medical Center 411 Fortuyn Rd Grand Coulee WA 99133-8718 Ph: (509) 633-1911 | Coulee Medical Center 411 Fortuyn Rd Grand Coulee WA 99133-8718 Ph: (509) 633-6375 |
NPI Number | 1457420218 |
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Provider Enumeration Date | 11/07/2006 |
Last Update Date | 07/07/2017 |
Medicare PECOS PAC ID | 9335050285 |
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Medicare Enrollment ID | O20050713000325 |
Identifier | Type | State | Issuer |
---|---|---|---|
1457420218 | NPI | - | NPPES |
1016404 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Coulee Community Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 411 Fortuyn Rd, Grand Coulee, WA 99133 Phone: 509-633-1753 Fax: 509-633-3644 | |
Coulee Community Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 411 Fortuyn Rd, Grand Coulee, WA 99133 Phone: 509-633-1753 Fax: 509-633-3644 | |
Coulee Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 411 Fortuyn Rd, Grand Coulee, WA 99133 Phone: 509-633-1753 | |
Coulee Community Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 411 Fortuyn Rd, Grand Coulee, WA 99133 Phone: 509-633-1753 Fax: 509-633-3644 | |
Coulee Community Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 411 Fortuyn Rd, Grand Coulee, WA 99133 Phone: 509-633-1753 Fax: 509-633-3644 |