| Wesconnett Community Health Center | |
|
5460 Blanding Blvd Jacksonville FL 32244-1957 | |
| (904) 760-4904 | |
| (904) 779-5263 |
| Full Name | Wesconnett Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 5460 Blanding Blvd, Jacksonville, Florida |
| Authorized Official Name and Position | Mia L Jones (CEO) |
| Authorized Official Contact | 9047604904 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wesconnett Community Health Center 5460 Blanding Blvd Jacksonville FL 32244-1957 Ph: (904) 760-4904 | Wesconnett Community Health Center 5460 Blanding Blvd Jacksonville FL 32244-1957 Ph: (904) 760-4904 |
| NPI Number | 1578928826 |
|---|---|
| Provider Enumeration Date | 12/30/2015 |
| Last Update Date | 12/22/2022 |
| Medicare PECOS PAC ID | 3476500695 |
|---|---|
| Medicare Enrollment ID | O20170105000019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578928826 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | N04000004094 (Florida) | Primary |
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