| Community Health Service Inc. | |
|
1804 Trott Ave Sw Willmar MN 56201-2743 | |
| (320) 214-7286 | |
| (320) 214-7223 |
| Full Name | Community Health Service Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1804 Trott Ave Sw, Willmar, Minnesota |
| Authorized Official Name and Position | Asim Khan (CFO) |
| Authorized Official Contact | 2184227424 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Health Service Inc. 810 4th Ave S Suite 101 Moorhead MN 56560-2800 Ph: (218) 236-6502 | Community Health Service Inc. 1804 Trott Ave Sw Willmar MN 56201-2743 Ph: (320) 214-7286 |
| NPI Number | 1497206197 |
|---|---|
| Provider Enumeration Date | 10/18/2016 |
| Last Update Date | 05/18/2023 |
| Medicare PECOS PAC ID | 4486930195 |
|---|---|
| Medicare Enrollment ID | O20170517000155 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497206197 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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