| Community Health Center Of Fort Dodge, Inc. | |
|
404 N Federal Ave Mason City IA 50401-3214 | |
| (641) 450-0601 | |
| (641) 450-0612 |
| Full Name | Community Health Center Of Fort Dodge, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 404 N Federal Ave, Mason City, Iowa |
| Authorized Official Name and Position | Renae Irene Elizabeth Kruckenberg (CEO) |
| Authorized Official Contact | 5155766500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Health Center Of Fort Dodge, Inc. 126 N 10th St Fort Dodge IA 50501-3915 Ph: (515) 576-6500 | Community Health Center Of Fort Dodge, Inc. 404 N Federal Ave Mason City IA 50401-3214 Ph: (641) 450-0601 |
| NPI Number | 1588160089 |
|---|---|
| Provider Enumeration Date | 04/03/2018 |
| Last Update Date | 03/01/2023 |
| Medicare PECOS PAC ID | 1557378627 |
|---|---|
| Medicare Enrollment ID | O20180822001766 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588160089 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 261QF0400X (Iowa) | Primary |
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