| West Side Community Health Services, Inc. | |
|
45 10th St W Saint Paul MN 55102-1062 | |
| (651) 602-7500 | |
| (651) 222-1305 |
| Full Name | West Side Community Health Services, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 45 10th St W, Saint Paul, Minnesota |
| Authorized Official Name and Position | Reuben Moore (CEO) |
| Authorized Official Contact | 6516027500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| West Side Community Health Services, Inc. 153 Cesar Chavez St Saint Paul MN 55107-2226 Ph: (651) 602-7500 | West Side Community Health Services, Inc. 45 10th St W Saint Paul MN 55102-1062 Ph: (651) 602-7500 |
| NPI Number | 1982346409 |
|---|---|
| Provider Enumeration Date | 04/13/2022 |
| Last Update Date | 05/15/2024 |
| Medicare PECOS PAC ID | 2062306434 |
|---|---|
| Medicare Enrollment ID | O20241108000396 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982346409 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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