| Neighborhood Medical Center, Inc | |
|
872 W Orange Ave Tallahassee FL 32310-6123 | |
| (850) 606-8226 | |
| Not Available |
| Full Name | Neighborhood Medical Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 872 W Orange Ave, Tallahassee, Florida |
| Authorized Official Name and Position | Nellie R Graham (CREDENTIALING MANAGER) |
| Authorized Official Contact | 8505770045 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neighborhood Medical Center, Inc 438 W Brevard St Tallahassee FL 32301-1004 Ph: (850) 577-0045 | Neighborhood Medical Center, Inc 872 W Orange Ave Tallahassee FL 32310-6123 Ph: (850) 606-8226 |
| NPI Number | 1851806079 |
|---|---|
| Provider Enumeration Date | 12/11/2017 |
| Last Update Date | 03/28/2023 |
| Medicare PECOS PAC ID | 7517082837 |
|---|---|
| Medicare Enrollment ID | O20140604000032 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851806079 | NPI | - | NPPES |
| 112813702 | Medicaid | FL | |
| 112812300 | Medicaid | FL | |
| 112863500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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