| Fqhc | |
|
1720 S Gadsden St Tallahassee FL 32301-5506 | |
| (850) 576-4073 | |
| (850) 576-2859 |
| Full Name | Fqhc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1720 S Gadsden St, Tallahassee, Florida |
| Authorized Official Name and Position | Dana Schultz (CFO) |
| Authorized Official Contact | 8505764073 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fqhc 1720 S Gadsden St Tallahassee FL 32301-5506 Ph: (850) 576-4073 | Fqhc 1720 S Gadsden St Tallahassee FL 32301-5506 Ph: (850) 576-4073 |
| NPI Number | 1396718409 |
|---|---|
| Provider Enumeration Date | 02/09/2006 |
| Last Update Date | 03/02/2023 |
| Medicare PECOS PAC ID | 5294646766 |
|---|---|
| Medicare Enrollment ID | O20031015000031 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396718409 | NPI | - | NPPES |
| 060551400 | Medicaid | FL | |
| 060551403 | Medicaid | FL | |
| 060551402 | Medicaid | FL | |
| 060551401 | Medicaid | FL | |
| 105009 | Other | FL | HEALTHEASE FLORIDA |
| 98705 | Other | FL | BLUE CROSS BLUE SHIELD/FL |
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