| Wesley Community Center Inc | |
|
1510 S 19th Dr Ste 100 Phoenix AZ 85009-6540 | |
| (602) 368-9896 | |
| Not Available |
| Full Name | Wesley Community Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1510 S 19th Dr Ste 100, Phoenix, Arizona |
| Authorized Official Name and Position | Blaine Bandi (CEO) |
| Authorized Official Contact | 6023689616 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wesley Community Center Inc 1300 S 10th St Phoenix AZ 85034-4516 Ph: (602) 368-9603 | Wesley Community Center Inc 1510 S 19th Dr Ste 100 Phoenix AZ 85009-6540 Ph: (602) 368-9896 |
| NPI Number | 1013547686 |
|---|---|
| Provider Enumeration Date | 01/22/2020 |
| Last Update Date | 04/09/2021 |
| Medicare PECOS PAC ID | 9032264239 |
|---|---|
| Medicare Enrollment ID | O20220118002308 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013547686 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| 261QH0100X | Clinic/center - Health Service | (* (Not Available)) | Secondary |
Richard A. Snider, Md, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12010 S Warner Elliot Loop, Phoenix, AZ 85044 Phone: 480-893-2644 | |
Kelly H. Roy, Md, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1008 E Mcdowell Rd, Phoenix, AZ 85006 Phone: 602-358-8588 Fax: 602-688-6991 | |
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