AUNT MARTHA'S HEALTH AND WELLNESS NPI 1043746720

NPI Information

AUNT MARTHA'S HEALTH AND WELLNESS is a federally qualified health center (fqhc) clinic center in Rockford, IL. AUNT MARTHA'S HEALTH AND WELLNESS NPI is 1043746720. The provider is registered as an organization entity type.
The provider Is Doing Business As Aunt Martha's Rockford Community Health Center.

The provider's business location address is:

1401 E STATE ST
SUITE 3000
ROCKFORD, IL
ZIP 61104-315
Phone: (877) 692-8686

The provider's authorized official is Audrey Pennington .
The authorized official title is Executive Vp Of Health and has the following contact phone number (773) 802-7645.

The CLIA number assigned to this NPI record is 14D2134322 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/2/2017 and was last updated on 5/2/2017.

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:

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