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60 O St Nw Washington DC 20001-1259 | |
| (202) 797-8806 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 60 O St Nw, Washington, District Of Columbia |
| Authorized Official Name and Position | Richard Gerlach (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2027978806 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
60 O St Nw Washington DC 20001-1259 Ph: (202) 797-8806 | 60 O St Nw Washington DC 20001-1259 Ph: (202) 797-8806 |
| NPI Number | 1063955177 |
|---|---|
| Provider Enumeration Date | 11/21/2016 |
| Last Update Date | 11/21/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063955177 | NPI | - | NPPES |
| 074882400 | Medicaid | DC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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