| Salvation Army | |
|
1907 Nw 38th St Ste 195 Miami FL 33142-5446 | |
| (305) 637-6720 | |
| (305) 635-1123 |
| Full Name | Salvation Army |
|---|---|
| Speciality | Clinic/Center |
| Location | 1907 Nw 38th St Ste 195, Miami, Florida |
| Authorized Official Name and Position | Francis Afram-gyening (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3055330189 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Salvation Army 336 Nw 5th St Miami FL 33128-1616 Ph: (305) 577-4840 | Salvation Army 1907 Nw 38th St Ste 195 Miami FL 33142-5446 Ph: (305) 637-6720 |
| NPI Number | 1659536365 |
|---|---|
| Provider Enumeration Date | 07/22/2008 |
| Last Update Date | 02/11/2021 |
| Certification Date | 02/11/2021 |
| Medicare PECOS PAC ID | 4688575210 |
|---|---|
| Medicare Enrollment ID | O20230530000219 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659536365 | NPI | - | NPPES |
| 680002514 | Medicaid | FL | |
| 680002505 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | () | Primary |
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