Primary Health Care, Inc. | |
2401 Se 14th St Des Moines IA 50320-1111 | |
(515) 336-4604 | |
(515) 248-1414 |
Full Name | Primary Health Care, Inc. |
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Speciality | Clinic/Center |
Location | 2401 Se 14th St, Des Moines, Iowa |
Authorized Official Name and Position | Kelly Ann Huntsman (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 5152481441 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Primary Health Care, Inc. 1200 University Ave Ste 200 Des Moines IA 50314-2355 Ph: (515) 248-1447 | Primary Health Care, Inc. 2401 Se 14th St Des Moines IA 50320-1111 Ph: (515) 336-4604 |
NPI Number | 1174139158 |
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Provider Enumeration Date | 09/16/2020 |
Last Update Date | 09/16/2020 |
Medicare PECOS PAC ID | 8426966755 |
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Medicare Enrollment ID | O20200921002294 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174139158 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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