Pulaski Clinic | |
100 Market St Pulaski IL 62976 | |
(618) 342-6767 | |
(618) 342-6868 |
Full Name | Pulaski Clinic |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 100 Market St, Pulaski, Illinois |
Authorized Official Name and Position | Frederick L Bernstein (CEO) |
Authorized Official Contact | 6184570450 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Pulaski Clinic Po Box 3008 Carbondale IL 62902-3008 Ph: (618) 457-0450 | Pulaski Clinic 100 Market St Pulaski IL 62976 Ph: (618) 342-6767 |
NPI Number | 1063404523 |
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Provider Enumeration Date | 08/19/2005 |
Last Update Date | 09/01/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1063404523 | NPI | - | NPPES |
1616948 | Other | IL | BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |