| Family Medical Center | |
|
1120 W Rose St Walla Walla WA 99362-1662 | |
| (509) 525-6650 | |
| (509) 522-2349 |
| Full Name | Family Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1120 W Rose St, Walla Walla, Washington |
| Authorized Official Name and Position | Shannon Fernandez (BILLING VP) |
| Authorized Official Contact | 5098656175 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medical Center Po Box 190 Toppenish WA 98948-0190 Ph: (509) 525-6650 | Family Medical Center 1120 W Rose St Walla Walla WA 99362-1662 Ph: (509) 525-6650 |
| NPI Number | 1700839727 |
|---|---|
| Provider Enumeration Date | 05/19/2006 |
| Last Update Date | 01/19/2023 |
| Medicare PECOS PAC ID | 4385541986 |
|---|---|
| Medicare Enrollment ID | O20100823000072 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700839727 | NPI | - | NPPES |
| 30680 | Other | WA | LABOR AND INDUSTRIES |
| 022793 | Medicaid | OR | |
| CG6158 | Other | WA | RAILROAD MEDICARE |
| 7034028 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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