| Brevard Health Alliance Inc | |
|
601 E University Blvd Melbourne FL 32901-7121 | |
| (321) 241-6800 | |
| (321) 241-6888 |
| Full Name | Brevard Health Alliance Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 601 E University Blvd, Melbourne, Florida |
| Authorized Official Name and Position | Angela Craig (DIRECTOR OF BILLING) |
| Authorized Official Contact | 3216983446 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brevard Health Alliance Inc Po Box 1137 Melbourne FL 32902-1137 Ph: (321) 952-9696 | Brevard Health Alliance Inc 601 E University Blvd Melbourne FL 32901-7121 Ph: (321) 241-6800 |
| NPI Number | 1073271763 |
|---|---|
| Provider Enumeration Date | 11/30/2021 |
| Last Update Date | 04/05/2022 |
| Medicare PECOS PAC ID | 0446201768 |
|---|---|
| Medicare Enrollment ID | O20220523002546 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073271763 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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