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General NPI Number Information
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NPI Number | 1093703639
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Entity Type | Organization
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Legal Business Name | PEOPLES COMMUNITY HEALTH CLINIC, INC.
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Dates
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Enumeration Date | 10/07/2005
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Last Update Date | 10/02/2018
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Provider Practice Location Address
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Address Line | 905 FRANKLIN ST
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City | WATERLOO
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State | IA
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Zip | 50703-4407
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Country | US
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Telephone | 319-272-4300
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Fax | 319-272-4321
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Provider Business Mailing Address
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Address Line | 905 FRANKLIN ST
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City | WATERLOO
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State | IA
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Zip | 50703-4407
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Country | US
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Telephone | 319-874-3000
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Fax | 319-874-3411
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Authorized Official
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Title or Position | CEO
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Name | CHRISTINE KEMP
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Credential | CEO
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Telephone | 319-874-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State | IA
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