| Crossing Healthcare On Water St | |
|
1027 N Water St Decatur IL 62523-1022 | |
| (217) 330-5676 | |
| (217) 330-5992 |
| Full Name | Crossing Healthcare On Water St |
|---|---|
| Speciality | Clinic/Center |
| Location | 1027 N Water St, Decatur, Illinois |
| Authorized Official Name and Position | Tanya Andricks (EXECUTIVE DIRECTOR/CEO) |
| Authorized Official Contact | 2178779117 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crossing Healthcare On Water St 320 E Central Ave Decatur IL 62521-4665 Ph: (217) 877-9117 | Crossing Healthcare On Water St 1027 N Water St Decatur IL 62523-1022 Ph: (217) 330-5676 |
| NPI Number | 1831635770 |
|---|---|
| Provider Enumeration Date | 01/17/2017 |
| Last Update Date | 02/10/2017 |
| Medicare PECOS PAC ID | 4385625342 |
|---|---|
| Medicare Enrollment ID | O20170614001581 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831635770 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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