| Community Health Center Of Pinellas Inc | |
|
1344 22nd St S St Petersburg FL 33712-2744 | |
| (727) 824-8181 | |
| Not Available |
| Full Name | Community Health Center Of Pinellas Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1344 22nd St S, St Petersburg, Florida |
| Authorized Official Name and Position | Edward Kucher (CHIEF REGULATORY OFFICER) |
| Authorized Official Contact | 7278248100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Health Center Of Pinellas Inc Po Box 10549 St Petersburg FL 33733-0549 Ph: (727) 824-8181 | Community Health Center Of Pinellas Inc 1344 22nd St S St Petersburg FL 33712-2744 Ph: (727) 824-8181 |
| NPI Number | 1194283382 |
|---|---|
| Provider Enumeration Date | 03/06/2019 |
| Last Update Date | 06/06/2025 |
| Medicare PECOS PAC ID | 8527961028 |
|---|---|
| Medicare Enrollment ID | O20190719000907 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194283382 | NPI | - | NPPES |
| 029565527 | Medicaid | FL | |
| 029565528 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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