Healthcare Provider Details

I. General information

NPI: 1285203612
Provider Name (Legal Business Name): WHEELER CLINIC INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2021
Last Update Date: 06/21/2021
Certification Date: 06/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 HART ST
NEW BRITAIN CT
06052-1743
US

IV. Provider business mailing address

91 NORTHWEST DRIVE
PLAINVILLE CT
06062-1552
US

V. Phone/Fax

Practice location:
  • Phone: 888-793-3500
  • Fax:
Mailing address:
  • Phone: 888-793-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ATHENA SZCZESNIAK
Title or Position: CFO
Credential:
Phone: 860-793-4235