| Charter Oak Health Center, Inc | |
|
32 Grand St Hartford CT 06106-4658 | |
| (860) 550-7500 | |
| (860) 550-7529 |
| Full Name | Charter Oak Health Center, Inc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 32 Grand St, Hartford, Connecticut |
| Authorized Official Name and Position | Tim Powers (CHIEF COMPLIANCE OFFICER) |
| Authorized Official Contact | 8605507500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Charter Oak Health Center, Inc 21 Grand St Ste 1 Hartford CT 06106-1541 Ph: (860) 550-7500 | Charter Oak Health Center, Inc 32 Grand St Hartford CT 06106-4658 Ph: (860) 550-7500 |
| NPI Number | 1114537578 |
|---|---|
| Provider Enumeration Date | 07/31/2020 |
| Last Update Date | 07/31/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114537578 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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