| Primary Health Care At Central Iowa Shelter & Services | |
|
1420 Mulberry St Des Moines IA 50309-3618 | |
| (515) 284-5719 | |
| (515) 248-1510 |
| Full Name | Primary Health Care At Central Iowa Shelter & Services |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1420 Mulberry St, Des Moines, Iowa |
| Authorized Official Name and Position | Kelly Huntsman (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5152481441 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Health Care At Central Iowa Shelter & Services 1200 University Ave Suite 200 Des Moines IA 50314-2355 Ph: (515) 248-1447 | Primary Health Care At Central Iowa Shelter & Services 1420 Mulberry St Des Moines IA 50309-3618 Ph: (515) 284-5719 |
| NPI Number | 1871716498 |
|---|---|
| Provider Enumeration Date | 04/11/2007 |
| Last Update Date | 09/23/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871716498 | NPI | - | NPPES |
| 37399 | Other | IA | WELLMARK BCBS |
| 0199174 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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