| Wendover Community Health Center | |
|
925 Wells Avenue Box 3520 West Wendover NV 89883 | |
| (775) 664-2220 | |
| (775) 664-2965 |
| Full Name | Wendover Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 925 Wells Avenue, West Wendover, Nevada |
| Authorized Official Name and Position | Walter B Davis (CEO) |
| Authorized Official Contact | 7758886610 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wendover Community Health Center 3325 Research Way Carson City NV 89706-7913 Ph: (775) 888-6610 | Wendover Community Health Center 925 Wells Avenue Box 3520 West Wendover NV 89883 Ph: (775) 664-2220 |
| NPI Number | 1033297304 |
|---|---|
| Provider Enumeration Date | 11/02/2006 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 7113835307 |
|---|---|
| Medicare Enrollment ID | O20080508000356 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033297304 | NPI | - | NPPES |
| 1033297304 | Medicaid | NV | |
| DQ468C | Other | NV | MEDICARE ID - TYPE UNSPECIFIED |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Nevada) | Primary |