| Shackelford County Community Resource Center | |
|
2802 W Walker St Breckenridge TX 76424-4000 | |
| (254) 559-7215 | |
| (254) 559-7213 |
| Full Name | Shackelford County Community Resource Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 2802 W Walker St, Breckenridge, Texas |
| Authorized Official Name and Position | Tina Louise Betcher (BILLING MANAGER/CREDENTIALER) |
| Authorized Official Contact | 3258934010 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shackelford County Community Resource Center Po Box 2435 Albany TX 76430-8020 Ph: (325) 762-2447 | Shackelford County Community Resource Center 2802 W Walker St Breckenridge TX 76424-4000 Ph: (254) 559-7215 |
| NPI Number | 1417248824 |
|---|---|
| Provider Enumeration Date | 04/20/2011 |
| Last Update Date | 10/12/2012 |
| Medicare PECOS PAC ID | 8628027174 |
|---|---|
| Medicare Enrollment ID | O20101110000421 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417248824 | NPI | - | NPPES |
| 171901504 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 30117281979 (Texas) | Primary |
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