| Mid-valley Family Medicine | |
|
620 W 1st St Wapato WA 98951-1108 | |
| (509) 877-4111 | |
| Not Available |
| Full Name | Mid-valley Family Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 620 W 1st St, Wapato, Washington |
| Authorized Official Name and Position | Juan Carlos Olivares (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5098656175 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid-valley Family Medicine Po Box 190 Toppenish WA 98948-0190 Ph: (509) 865-6175 | Mid-valley Family Medicine 620 W 1st St Wapato WA 98951-1108 Ph: (509) 877-4111 |
| NPI Number | 1740459833 |
|---|---|
| Provider Enumeration Date | 02/22/2008 |
| Last Update Date | 02/22/2008 |
| Medicare PECOS PAC ID | 4385541986 |
|---|---|
| Medicare Enrollment ID | O20201026003204 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740459833 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Mobile Unit Ronald Mcdonald Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 618b W 1st St, Wapato, WA 98951 Phone: 509-575-8457 |