Fredericksburg Family Health Clinic, Pllc | |
115 Schult Ridge Rd Fredericksburg IA 50630-9582 | |
(563) 237-5316 | |
Not Available |
Full Name | Fredericksburg Family Health Clinic, Pllc |
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Speciality | Clinic/Center |
Location | 115 Schult Ridge Rd, Fredericksburg, Iowa |
Authorized Official Name and Position | Lucas Brinkman (OWNER) |
Authorized Official Contact | 5632375316 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Fredericksburg Family Health Clinic, Pllc 115 Schult Ridge Rd Fredericksburg IA 50630-9582 Ph: (563) 237-5316 | Fredericksburg Family Health Clinic, Pllc 115 Schult Ridge Rd Fredericksburg IA 50630-9582 Ph: (563) 237-5316 |
NPI Number | 1548596927 |
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Provider Enumeration Date | 10/20/2009 |
Last Update Date | 10/20/2009 |
Medicare PECOS PAC ID | 0840332888 |
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Medicare Enrollment ID | O20100128000624 |
Identifier | Type | State | Issuer |
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1548596927 | NPI | - | NPPES |
0130401 | Medicaid | IA |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | 3824 (Iowa) | Primary |
Provider Name | Lucas J Brinkman |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1811003031 PECOS PAC ID: 0446341887 Enrollment ID: I20070814000431 |
Fredericksburg Family Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 115 Schult Ridge Rd, Fredericksburg, IA 50630 Phone: 563-237-5316 Fax: 563-237-6337 |