| Fairmont City Health Center | |
|
2568 N 41st St East Saint Louis IL 62201-2204 | |
| (618) 482-4015 | |
| (618) 482-4806 |
| Full Name | Fairmont City Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 2568 N 41st St, East Saint Louis, Illinois |
| Authorized Official Name and Position | Larry Mcculley (PRESIDENT) |
| Authorized Official Contact | 6183320783 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairmont City Health Center 8080 State St East Saint Louis IL 62203-1808 Ph: (618) 397-3303 | Fairmont City Health Center 2568 N 41st St East Saint Louis IL 62201-2204 Ph: (618) 482-4015 |
| NPI Number | 1770648917 |
|---|---|
| Provider Enumeration Date | 12/27/2006 |
| Last Update Date | 07/29/2009 |
| Medicare PECOS PAC ID | 1456256874 |
|---|---|
| Medicare Enrollment ID | O20081030000237 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770648917 | NPI | - | NPPES |
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