| Potter Valley Community Health Ctr | |
|
10175 Main St Potter Valley CA 95469-9749 | |
| (707) 743-1188 | |
| (707) 743-1192 |
| Full Name | Potter Valley Community Health Ctr |
|---|---|
| Speciality | Clinic/center |
| Location | 10175 Main St, Potter Valley, California |
| Authorized Official Name and Position | Jill N Carter (EX DIRECTOR) |
| Authorized Official Contact | 7077431188 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Potter Valley Community Health Ctr Po Box 238 Potter Valley CA 95469-0238 Ph: (707) 743-1188 | Potter Valley Community Health Ctr 10175 Main St Potter Valley CA 95469-9749 Ph: (707) 743-1188 |
| NPI Number | 1083600894 |
|---|---|
| Provider Enumeration Date | 09/27/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083600894 | NPI | - | NPPES |
| FHC03879F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | FHC03879F (California) | Primary |