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115 S Park Ave Eagle Grove IA 50533-2219 | |
| (515) 448-5185 | |
| (515) 448-4405 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 115 S Park Ave, Eagle Grove, Iowa |
| Authorized Official Name and Position | Leah M Glasgo (MARKET PRESIDENT) |
| Authorized Official Contact | 5155733101 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
802 Kenyon Rd Fort Dodge IA 50501-5740 Ph: (515) 574-6565 | 115 S Park Ave Eagle Grove IA 50533-2219 Ph: (515) 448-5185 |
| NPI Number | 1609394345 |
|---|---|
| Provider Enumeration Date | 09/01/2017 |
| Last Update Date | 11/19/2024 |
| Medicare PECOS PAC ID | 7315858529 |
|---|---|
| Medicare Enrollment ID | O20171204001761 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609394345 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Community Health Center Of Fort Dodge, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 306 W Broadway St, Eagle Grove, IA 50533 Phone: 515-576-6500 Fax: 515-576-1951 | |