| Jessie Trice Community Health System Inc | |
|
2985 Nw 54th St Miami FL 33142-2827 | |
| (305) 637-6498 | |
| (305) 805-1715 |
| Full Name | Jessie Trice Community Health System Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2985 Nw 54th St, Miami, Florida |
| Authorized Official Name and Position | Annie R Neasman (PRESIDENT AND CEO) |
| Authorized Official Contact | 3058051700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jessie Trice Community Health System Inc 5607 Nw 27th Ave Ste 1 Miami FL 33142-2826 Ph: (305) 805-1700 | Jessie Trice Community Health System Inc 2985 Nw 54th St Miami FL 33142-2827 Ph: (305) 637-6498 |
| NPI Number | 1114180908 |
|---|---|
| Provider Enumeration Date | 07/02/2008 |
| Last Update Date | 03/18/2020 |
| Medicare PECOS PAC ID | 2961486733 |
|---|---|
| Medicare Enrollment ID | O20081018000258 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114180908 | NPI | - | NPPES |
| 029541862 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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