| Terrier Care | |
|
1301 E Walnut St Rm J120 Carbondale IL 62901-5004 | |
| (618) 457-3371 | |
| (618) 457-8931 |
| Full Name | Terrier Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 1301 E Walnut St Rm J120, Carbondale, Illinois |
| Authorized Official Name and Position | Christina Carney (CEO) |
| Authorized Official Contact | 6189569521 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Terrier Care 109 California St P O Box 577 Carterville IL 62918-0577 Ph: (618) 985-8221 | Terrier Care 1301 E Walnut St Rm J120 Carbondale IL 62901-5004 Ph: (618) 457-3371 |
| NPI Number | 1326079245 |
|---|---|
| Provider Enumeration Date | 07/06/2006 |
| Last Update Date | 04/05/2024 |
| Medicare PECOS PAC ID | 1658285671 |
|---|---|
| Medicare Enrollment ID | O20050511000210 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326079245 | NPI | - | NPPES |
| 640702 | Other | MEDICARE GROUP NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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