| Jordan Creek Family Medical Clinic Pc | |
|
230 S 68th St Suite 220 West Des Moines IA 50266-8176 | |
| (515) 457-8517 | |
| Not Available |
| Full Name | Jordan Creek Family Medical Clinic Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 230 S 68th St, West Des Moines, Iowa |
| Authorized Official Name and Position | Basil Saadi Hassan (PRESIDENT/CEO) |
| Authorized Official Contact | 5154578517 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jordan Creek Family Medical Clinic Pc 230 S 68th St Suite 220 West Des Moines IA 50266-8176 Ph: (515) 457-8517 | Jordan Creek Family Medical Clinic Pc 230 S 68th St Suite 220 West Des Moines IA 50266-8176 Ph: (515) 457-8517 |
| NPI Number | 1356378772 |
|---|---|
| Provider Enumeration Date | 06/28/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 7911901046 |
|---|---|
| Medicare Enrollment ID | O20060905000070 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356378772 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 35490 (Iowa) | Primary |
| Provider Name | Basil Saadi Hassan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932180437 PECOS PAC ID: 4082603048 Enrollment ID: I20040506001234 |
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