| Siouxland Community Health Center Of Nebraska | |
|
3410 Futures Dr South Sioux City NE 68776-3917 | |
| (712) 252-2477 | |
| Not Available |
| Full Name | Siouxland Community Health Center Of Nebraska |
|---|---|
| Speciality | Clinic/Center |
| Location | 3410 Futures Dr, South Sioux City, Nebraska |
| Authorized Official Name and Position | Jan M Anderson (CFO) |
| Authorized Official Contact | 7122021002 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Siouxland Community Health Center Of Nebraska 1021 Nebraska St Sioux City IA 51105-1436 Ph: (712) 252-2477 | Siouxland Community Health Center Of Nebraska 3410 Futures Dr South Sioux City NE 68776-3917 Ph: (712) 252-2477 |
| NPI Number | 1912378480 |
|---|---|
| Provider Enumeration Date | 10/09/2015 |
| Last Update Date | 06/08/2017 |
| Medicare PECOS PAC ID | 9931099546 |
|---|---|
| Medicare Enrollment ID | O20151125001899 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912378480 | NPI | - | NPPES |
| 0092080 | Medicaid | IA | |
| 281840 | Other | IA | MEDICARE OSCAR/CERTIFICATION |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
South Sioux Mercy Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 501 1st Ave, South Sioux City, NE 68776 Phone: 402-494-3064 Fax: 402-494-2656 |