| Family Health Network Mobile Van | |
|
85 S West St Homer NY 13077-1542 | |
| (607) 753-3797 | |
| (607) 753-6677 |
| Full Name | Family Health Network Mobile Van |
|---|---|
| Speciality | Clinic/Center |
| Location | 85 S West St, Homer, New York |
| Authorized Official Name and Position | Kimberly Osborne (CEO) |
| Authorized Official Contact | 6077533797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Health Network Mobile Van 85 S West St Homer NY 13077-1542 Ph: (607) 753-3797 | Family Health Network Mobile Van 85 S West St Homer NY 13077-1542 Ph: (607) 753-3797 |
| NPI Number | 1780633982 |
|---|---|
| Provider Enumeration Date | 05/08/2006 |
| Last Update Date | 10/21/2022 |
| Medicare PECOS PAC ID | 2668385014 |
|---|---|
| Medicare Enrollment ID | O20221115003164 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780633982 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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