Potter Valley Community Health Ctr | |
10175 Main St Potter Valley CA 95469-9749 | |
(707) 743-1188 | |
(707) 743-1192 |
Full Name | Potter Valley Community Health Ctr |
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Speciality | Clinic/center |
Location | 10175 Main St, Potter Valley, California |
Authorized Official Name and Position | Jill N Carter (EX DIRECTOR) |
Authorized Official Contact | 7077431188 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Potter Valley Community Health Ctr Po Box 238 Potter Valley CA 95469-0238 Ph: (707) 743-1188 | Potter Valley Community Health Ctr 10175 Main St Potter Valley CA 95469-9749 Ph: (707) 743-1188 |
NPI Number | 1083600894 |
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Provider Enumeration Date | 09/27/2005 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083600894 | NPI | - | NPPES |
FHC03879F | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | FHC03879F (California) | Primary |