| West Side Community Health Services, Inc. | |
|
435 University Ave E Saint Paul MN 55101-4437 | |
| (651) 290-6814 | |
| (651) 602-7580 |
| Full Name | West Side Community Health Services, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 435 University Ave E, 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. 435 University Ave E Saint Paul MN 55101-4437 Ph: (651) 290-6814 |
| NPI Number | 1104977255 |
|---|---|
| Provider Enumeration Date | 01/16/2007 |
| Last Update Date | 03/03/2025 |
| Medicare PECOS PAC ID | 2062306434 |
|---|---|
| Medicare Enrollment ID | O20061117000438 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104977255 | NPI | - | NPPES |
| 106738 | Other | MN | UCARE |
| 076982000 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Minnesota) | Primary |
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