| Russian River Health Center | |
|
16387 First St Guerneville CA 95446 | |
| (707) 869-2849 | |
| (707) 869-1477 |
| Full Name | Russian River Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 16387 First St, Guerneville, California |
| Authorized Official Name and Position | Vikki Minnifield (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 7072717052 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Russian River Health Center Po Box 1446 Guerneville CA 95446-1446 Ph: (707) 869-2849 | Russian River Health Center 16387 First St Guerneville CA 95446 Ph: (707) 869-2849 |
| NPI Number | 1356344758 |
|---|---|
| Provider Enumeration Date | 05/31/2005 |
| Last Update Date | 01/29/2024 |
| Medicare PECOS PAC ID | 6800782277 |
|---|---|
| Medicare Enrollment ID | O20081209000567 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356344758 | NPI | - | NPPES |
| FHC03887F | Medicaid | CA | |
| ZZZ73222Z | Other | CA | BLUE SHIELD PIN |
| HAP03887F | Other | CA | FPACT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | XXXXXXX (California) | Primary |
Russian River Health Center Bldg #2 Annex Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 16312 Third St, Guerneville, CA 95446 Phone: 707-869-5977 Fax: 707-869-5976 | |
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 | |
Russian River Health Center Building #2 Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 16312 Third Street, Guerneville, CA 95446 Phone: 707-869-2933 Fax: 707-869-2663 | |
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 |