| Primary Health Care-west Side Clinic | |
|
7555 Hickman Rd Urbandale IA 50322-4620 | |
| (515) 225-7201 | |
| (515) 225-9213 |
| Full Name | Primary Health Care-west Side Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 7555 Hickman Rd, Urbandale, Iowa |
| Authorized Official Name and Position | Kelly 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 |
|---|---|
| Primary Health Care-west Side Clinic 1200 University Ave Ste 200 Des Moines IA 50314-2355 Ph: (515) 248-1447 | Primary Health Care-west Side Clinic 7555 Hickman Rd Urbandale IA 50322-4620 Ph: (515) 225-7201 |
| NPI Number | 1396270831 |
|---|---|
| Provider Enumeration Date | 04/21/2017 |
| Last Update Date | 06/11/2020 |
| Medicare PECOS PAC ID | 8426966755 |
|---|---|
| Medicare Enrollment ID | O20170509001463 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396270831 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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