| Latah Community Health | |
|
803 S. Main Street Ste 120 Moscow ID 83843 | |
| (509) 444-8888 | |
| (509) 444-7806 |
| Full Name | Latah Community Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 803 S. Main Street, Moscow, Idaho |
| Authorized Official Name and Position | Aaron Wilson (CEO) |
| Authorized Official Contact | 5094448888 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Latah Community Health 611 N Iron Bridge Way Spokane WA 99202-4932 Ph: (509) 444-8888 | Latah Community Health 803 S. Main Street Ste 120 Moscow ID 83843 Ph: (509) 444-8888 |
| NPI Number | 1285077230 |
|---|---|
| Provider Enumeration Date | 04/09/2013 |
| Last Update Date | 09/29/2021 |
| Medicare PECOS PAC ID | 9638063217 |
|---|---|
| Medicare Enrollment ID | O20140307000218 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285077230 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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