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16312 Third Street Guerneville CA 95446 | |
(707) 869-2933 | |
(707) 869-2663 |
Full Name | |
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Speciality | Clinic/Center |
Location | 16312 Third Street, Guerneville, California |
Authorized Official Name and Position | Tari M Wallace (BILLING MANAGER) |
Authorized Official Contact | 7078695977 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 1449 Guerneville CA 95446-1449 Ph: (707) 869-2933 | 16312 Third Street Guerneville CA 95446 Ph: (707) 869-2933 |
NPI Number | 1598786352 |
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Provider Enumeration Date | 07/21/2006 |
Last Update Date | 02/28/2008 |
Medicare PECOS PAC ID | 6800782277 |
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Medicare Enrollment ID | O20070723000910 |
Identifier | Type | State | Issuer |
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1598786352 | NPI | - | NPPES |
FHC70957F | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | XXXXXXX (California) | Primary |
West County Health Centers, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 16319 Third Street, Guerneville, CA 95446 Phone: 707-869-5977 Fax: 707-869-5983 | |
West County Health Centers, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 16385 First St., Guerneville, CA 95446 Phone: 707-869-2849 |