Ritzville Medical Clinic | |
903 S Adams St Ritzville WA 99169-2227 | |
(509) 659-5402 | |
(509) 659-1252 |
Full Name | Ritzville Medical Clinic |
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Speciality | Clinic/Center |
Location | 903 S Adams St, Ritzville, Washington |
Authorized Official Name and Position | Tamra Combs (CREDENTALING) |
Authorized Official Contact | 5096591200 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Ritzville Medical Clinic 903 S Adams St Ritzville WA 99169-2227 Ph: (509) 659-5402 | Ritzville Medical Clinic 903 S Adams St Ritzville WA 99169-2227 Ph: (509) 659-5402 |
NPI Number | 1659387041 |
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Provider Enumeration Date | 07/31/2006 |
Last Update Date | 01/23/2024 |
Medicare PECOS PAC ID | 8022906122 |
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Medicare Enrollment ID | O20040309001448 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659387041 | NPI | - | NPPES |
8157364 | Medicaid | WA | |
7105489 | Medicaid | WA | |
7144503 | Medicaid | WA | |
0050906 | Other | WA | WA L&I |
0148592 | Other | WA | WA L&I |
0156841 | Other | WA | WA L&I |
8119547 | Medicaid | WA | |
0203688 | Other | WA | WA L&I |
0051688 | Other | WA | WA L&I |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Provider Name | Charles M Sackmann |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1396759635 PECOS PAC ID: 6204850191 Enrollment ID: I20060118000744 |
Hometown Family Medicine Ps Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 210 W Main Ave, Ritzville, WA 99169 Phone: 509-659-4800 Fax: 509-659-4801 |