| West County Health Centers, Inc. | |
|
3802 Main Street Occidental CA 95464 | |
| (707) 874-2444 | |
| (707) 874-1664 |
| Full Name | West County Health Centers, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 3802 Main Street, Occidental, California |
| Authorized Official Name and Position | Tari M Wallace (BILLING DIRECTOR) |
| Authorized Official Contact | 7078695977 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| West County Health Centers, Inc. Po Box 1449 Guerneville CA 95446-1449 Ph: (707) 874-2444 | West County Health Centers, Inc. 3802 Main Street Occidental CA 95464 Ph: (707) 874-2444 |
| NPI Number | 1598768962 |
|---|---|
| Provider Enumeration Date | 05/31/2005 |
| Last Update Date | 01/23/2008 |
| Medicare PECOS PAC ID | 6800782277 |
|---|---|
| Medicare Enrollment ID | O20110908001832 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598768962 | NPI | - | NPPES |
| HAP03899G | Other | CA | FPACT |
| ZZZ23666Z | Other | CA | BLUE SHIELD PIN |
| FHC03899G | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (California) | Primary |