| Peninsula Community Health Services | |
|
2003 Ne Hostmark Street Room Clinic P10 Poulsbo WA 98370 | |
| (360) 377-3776 | |
| Not Available |
| Full Name | Peninsula Community Health Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 2003 Ne Hostmark Street, Poulsbo, Washington |
| Authorized Official Name and Position | Bruce Brazier (ADMINISTRATIVE SERVICES DIRECTOR) |
| Authorized Official Contact | 3604756715 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peninsula Community Health Services Po Box 960 Bremerton WA 98337-0212 Ph: (360) 377-3776 | Peninsula Community Health Services 2003 Ne Hostmark Street Room Clinic P10 Poulsbo WA 98370 Ph: (360) 377-3776 |
| NPI Number | 1265217517 |
|---|---|
| Provider Enumeration Date | 08/25/2023 |
| Last Update Date | 08/25/2023 |
| Medicare PECOS PAC ID | 9436044781 |
|---|---|
| Medicare Enrollment ID | O20231212001092 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265217517 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
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