Smith House Health Care Center | |
39 Farrell Rd Willsboro NY 12996-3904 | |
(518) 963-4275 | |
Not Available |
Full Name | Smith House Health Care Center |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 39 Farrell Rd, Willsboro, New York |
Authorized Official Name and Position | Robin A. Pierce (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 5189634275 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Smith House Health Care Center 39 Farrell Rd Willsboro NY 12996-3904 Ph: (518) 963-4275 | Smith House Health Care Center 39 Farrell Rd Willsboro NY 12996-3904 Ph: (518) 963-4275 |
NPI Number | 1902960610 |
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Provider Enumeration Date | 12/20/2006 |
Last Update Date | 08/18/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1902960610 | NPI | - | NPPES |
00473478 | Medicaid | NY | |
FQHCLA218 | Other | NY | 340B ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 1566200R (New York) | Primary |