| New Health Springdale Medical | |
|
114 S Main Springdale WA 99173 | |
| (509) 258-4234 | |
| (509) 258-4499 |
| Full Name | New Health Springdale Medical |
|---|---|
| Speciality | Clinic/Center |
| Location | 114 S Main, Springdale, Washington |
| Authorized Official Name and Position | Donna Poe (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 5099356001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Health Springdale Medical Po Box 808 Chewelah WA 99109-0808 Ph: (509) 935-6001 | New Health Springdale Medical 114 S Main Springdale WA 99173 Ph: (509) 258-4234 |
| NPI Number | 1104880004 |
|---|---|
| Provider Enumeration Date | 04/17/2006 |
| Last Update Date | 07/18/2023 |
| Medicare PECOS PAC ID | 1951202373 |
|---|---|
| Medicare Enrollment ID | O20120316000349 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104880004 | NPI | - | NPPES |
| 7034127 | Medicaid | WA | |
| 7034465 | Medicaid | WA | |
| 80300 | Other | WA | LABOR AND INDUSTRIES ID |
| CE9078 | Other | WA | RR MEDICARE PIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | J600317870 (Washington) | Primary |