| Walnut Street Community Health Center, Inc. | |
|
201 S Cleveland Ave Hagerstown MD 21740-5745 | |
| (301) 745-3777 | |
| (301) 393-3428 |
| Full Name | Walnut Street Community Health Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 201 S Cleveland Ave, Hagerstown, Maryland |
| Authorized Official Name and Position | David F Becker (CFO) |
| Authorized Official Contact | 3017453777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Walnut Street Community Health Center, Inc. 201 S Cleveland Ave Hagerstown MD 21740-5745 Ph: (301) 745-3777 | Walnut Street Community Health Center, Inc. 201 S Cleveland Ave Hagerstown MD 21740-5745 Ph: (301) 745-3777 |
| NPI Number | 1366425266 |
|---|---|
| Provider Enumeration Date | 11/23/2005 |
| Last Update Date | 12/05/2023 |
| Medicare PECOS PAC ID | 6305757402 |
|---|---|
| Medicare Enrollment ID | O20030922000032 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366425266 | NPI | - | NPPES |
| 211841 | Other | MD | MEDICARE PROVIDER # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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