| Community Health Service Inc. | |
|
2310 4th Ave N Moorhead MN 56560-2473 | |
| (218) 236-6502 | |
| (218) 236-6507 |
| Full Name | Community Health Service Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2310 4th Ave N, Moorhead, Minnesota |
| Authorized Official Name and Position | Rhonda Eastlund (CEO) |
| Authorized Official Contact | 5072065756 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Health Service Inc. 2310 4th Ave N Moorhead MN 56560-2473 Ph: (218) 236-6502 | Community Health Service Inc. 2310 4th Ave N Moorhead MN 56560-2473 Ph: (218) 236-6502 |
| NPI Number | 1316921406 |
|---|---|
| Provider Enumeration Date | 12/01/2005 |
| Last Update Date | 10/01/2025 |
| Medicare PECOS PAC ID | 4486930195 |
|---|---|
| Medicare Enrollment ID | O20170504002365 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316921406 | NPI | - | NPPES |
| 596253600 | Medicaid | MN | |
| 05906 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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