| Homeless Clinic | |
|
921 S. Edwin C. Moses Blvd. Dayton OH 45417-3464 | |
| (937) 734-6844 | |
| Not Available |
| Full Name | Homeless Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 921 S. Edwin C. Moses Blvd., Dayton, Ohio |
| Authorized Official Name and Position | Gina Mcfarlane-el (CEO) |
| Authorized Official Contact | 9377346841 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Homeless Clinic 2261 Philadelphia Dr. Dayton OH 45406 Ph: (937) 734-6844 | Homeless Clinic 921 S. Edwin C. Moses Blvd. Dayton OH 45417-3464 Ph: (937) 734-6844 |
| NPI Number | 1750761813 |
|---|---|
| Provider Enumeration Date | 06/04/2015 |
| Last Update Date | 06/04/2015 |
| Medicare PECOS PAC ID | 9335300904 |
|---|---|
| Medicare Enrollment ID | O20150813010923 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750761813 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Ohio) | Primary |
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