| United Community Center Geriatric Clinic | |
|
730 W Washington St Milwaukee WI 53204-2310 | |
| (414) 672-1353 | |
| (262) 408-5094 |
| Full Name | United Community Center Geriatric Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 730 W Washington St, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Maria Cecilia S Taylor (CFO) |
| Authorized Official Contact | 4148036395 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| United Community Center Geriatric Clinic Po Box 778789 Chicago IL 60677-8789 Ph: (414) 672-1353 | United Community Center Geriatric Clinic 730 W Washington St Milwaukee WI 53204-2310 Ph: (414) 672-1353 |
| NPI Number | 1649559642 |
|---|---|
| Provider Enumeration Date | 08/08/2011 |
| Last Update Date | 05/15/2023 |
| Medicare PECOS PAC ID | 6709876857 |
|---|---|
| Medicare Enrollment ID | O20120104000532 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649559642 | NPI | - | NPPES |
| 1649559642 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 1507-800 (Wisconsin) | Primary |
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