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WEST SIDE COMMUNITY HEALTH SERVICES INC. NPI 1427106871


NPI Information

NPI: 1427106871
Provider Name: WEST SIDE COMMUNITY HEALTH SERVICES, INC.

Doing Business As: EAST SIDE FAMILY CLINIC

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

Specialization: Federally Qualified Health Center (FQHC)

Address:
860 ARCADE ST
SAINT PAUL, MN
ZIP 55106
Phone: (651) 772-9757
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WEST SIDE COMMUNITY HEALTH SERVICES, INC. is a federally qualified health center (fqhc) clinic center in Saint Paul, MN. WEST SIDE COMMUNITY HEALTH SERVICES, INC. NPI is 1427106871. The provider is registered as an organization entity type.
The provider Is Doing Business As East Side Family Clinic.

The provider's business location address is:

860 ARCADE ST
SAINT PAUL, MN
ZIP 55106-852
Phone: (651) 772-9757
Fax: (651) 772-9959

The provider's authorized official is Mavis Carol Brehm .
The authorized official title is Executive Director and has the following contact phone number (651) 602-7536.

The enumeration date for this NPI number is 1/8/2007 and was last updated on 6/18/2008.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)MINNESOTAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1241841MEDICARE OSCAR/CERTIFICATIONMINNESOTA
2C00143MEDICARE PINMINNESOTA
3377150400MEDICAIDMINNESOTA
4104017OTHERMINNESOTAUCARE FACILITY ID

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: 4/28/2024

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