PRIMARY HEALTH CARE INC. NPI 1124177407

NPI Information

NPI: 1124177407
Provider Name: PRIMARY HEALTH CARE, INC.

Doing Business As: PRIMARY HEALTH CARE-EAST SIDE CLINIC

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
3509 E 29TH ST
DES MOINES, IA
ZIP 50317
Phone: (515) 248-1600
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PRIMARY HEALTH CARE, INC. is a federally qualified health center (fqhc) clinic center in Des Moines, IA. PRIMARY HEALTH CARE, INC. NPI is 1124177407. The provider is registered as an organization entity type.
The provider Is Doing Business As Primary Health Care-east Side Clinic.

The provider's business location address is:

3509 E 29TH ST
DES MOINES, IA
ZIP 50317-253
Phone: (515) 248-1600
Fax: (515) 248-1610

The provider's authorized official is Kelly Huntsman .
The authorized official title is Chief Executive Officer and has the following contact phone number (515) 248-1441.

The enumeration date for this NPI number is 1/9/2007 and was last updated on 9/23/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	NA	IOWA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	35586	OTHER	IOWA	WELLMARK BCBS
2	0281857	MEDICAID	IOWA
3	161818	MEDICARE OSCAR/CERTIFICATION	IOWA
4	I9909	MEDICARE PIN	IOWA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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