| Westside Family Healthcare, Inc. | |
|
1802 W 4th St Wilmington DE 19805-3420 | |
| (302) 655-5822 | |
| (302) 655-5949 |
| Full Name | Westside Family Healthcare, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1802 W 4th St, Wilmington, Delaware |
| Authorized Official Name and Position | Lolita A. Lopez (PRESIDENT/CEO) |
| Authorized Official Contact | 3026568292 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Westside Family Healthcare, Inc. Po Box 151 New Castle DE 19720-0151 Ph: (302) 655-2822 | Westside Family Healthcare, Inc. 1802 W 4th St Wilmington DE 19805-3420 Ph: (302) 655-5822 |
| NPI Number | 1669479929 |
|---|---|
| Provider Enumeration Date | 07/01/2005 |
| Last Update Date | 04/20/2022 |
| Medicare PECOS PAC ID | 6800706599 |
|---|---|
| Medicare Enrollment ID | O20080805000526 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669479929 | NPI | - | NPPES |
| 0000356566 | Medicaid | DE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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