Vienna Medical Clinic | |
803 N 1st St Vienna IL 62995 | |
(618) 658-2811 | |
(618) 658-2439 |
Full Name | Vienna Medical Clinic |
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Speciality | Clinic/Center |
Location | 803 N 1st St, Vienna, Illinois |
Authorized Official Name and Position | Cynthia K Flamm (CEO) |
Authorized Official Contact | 6188334471 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Vienna Medical Clinic 513 N Main St Anna IL 62906-1668 Ph: (618) 833-4471 | Vienna Medical Clinic 803 N 1st St Vienna IL 62995 Ph: (618) 658-2811 |
NPI Number | 1932263332 |
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Provider Enumeration Date | 12/20/2006 |
Last Update Date | 09/05/2018 |
Medicare PECOS PAC ID | 6800705427 |
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Medicare Enrollment ID | O20080212000419 |
Identifier | Type | State | Issuer |
---|---|---|---|
1932263332 | NPI | - | NPPES |
9115004 | Other | IL | BLUE CROSS BLUE SHIELD |
055761 | Other | IL | HEALTH ALLIANCE |
111760 | Other | IL | HEALTHLINK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |