| Granger Family Medicine Clinic | |
|
115 Sunnyside Avenue Granger WA 98932 | |
| (509) 865-6175 | |
| Not Available |
| Full Name | Granger Family Medicine Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 115 Sunnyside Avenue, Granger, Washington |
| Authorized Official Name and Position | Juan C Olivares (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5098656175 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Granger Family Medicine Clinic Po Box 190 Toppenish WA 98948-0190 Ph: (509) 865-6175 | Granger Family Medicine Clinic 115 Sunnyside Avenue Granger WA 98932 Ph: (509) 865-6175 |
| NPI Number | 1710422407 |
|---|---|
| Provider Enumeration Date | 01/04/2017 |
| Last Update Date | 05/19/2021 |
| Medicare PECOS PAC ID | 4385541986 |
|---|---|
| Medicare Enrollment ID | O20201026001731 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710422407 | NPI | - | NPPES |
| 261QF0400X | Other | TAXONOMY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Yakima Neighborhood Health Services Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 112 Main Street, Granger, WA 98932 Phone: 509-383-6172 Fax: 509-383-6173 | |
Granger Medical Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 111 Main Street, Granger, WA 98932 Phone: 509-454-4143 | |
Yakima Neighborhood Health Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 111 Main Street, Granger, WA 98932 Phone: 509-454-4143 |