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Organization

COMMUNITY HEALTH CENTERS OF SOUTHEASTERN IOWA INC

Active
Other names
Tri-State Medical Group Inc
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. APRIL K SCHNEDLER (LEAD BILLING COORDINATOR)
(319) 768-5809
Entity
Organization

Contact information

Practice address
345 POLK ST, WARSAW, IL 62379-1033
(217) 256-3013
(319) 753-2301
Mailing address
1706 WEST AGENCY ROAD, WEST BURLINGTON, IA 52655
(319) 768-5858
(319) 753-2301

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0563882
IA
01
3422957
BLUE CROSS BLUE SHIELD
IL
05
506089424
MO
Enumeration date
01/26/2006
Last updated
10/19/2010
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