| Harrisburg Medical Clinic | |
|
205 N Main St Harrisburg IL 62946-1272 | |
| (618) 253-8450 | |
| (618) 253-8454 |
| Full Name | Harrisburg Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 205 N Main St, Harrisburg, Illinois |
| Authorized Official Name and Position | Frederick Bernstein (C.E.O.) |
| Authorized Official Contact | 6184570450 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Harrisburg Medical Clinic Po Box 3008 Carbondale IL 62902-3008 Ph: (618) 457-0450 | Harrisburg Medical Clinic 205 N Main St Harrisburg IL 62946-1272 Ph: (618) 253-8450 |
| NPI Number | 1013976919 |
|---|---|
| Provider Enumeration Date | 03/20/2006 |
| Last Update Date | 09/01/2010 |
| Medicare PECOS PAC ID | 0749194702 |
|---|---|
| Medicare Enrollment ID | O20050914000626 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013976919 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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Primary Care Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 117 E Clark St, Harrisburg, IL 62946 Phone: 618-252-8625 Fax: 618-252-2540 |