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NPI Code Detail

MEDICARE: BARTZ-ALTADONNA COMMUNITY HEALTH CENTER

MEDICARE: BARTZ-ALTADONNA COMMUNITY HEALTH CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
2251X00000XSupports Brokerage Agency
3261QF0400XFederally Qualified Health Center (FQHC)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811279763
Entity Type Code : Organization
Provider Name (Legal Business Name) : BARTZ-ALTADONNA COMMUNITY HEALTH CENTER
Provider Business Mailing Address
First Line : 43322 GINGHAM AVE
Second Line :
City : LANCASTER
State : CA
Zip : 93535-4576
Country : US
Telephone Number : 661-874-4050
Fax Number : 661-942-3500
Provider Business Practice Location Address
First Line : 43322 GINGHAM AVE
Second Line :
City : LANCASTER
State : CA
Zip : 93535-4576
Country : US
Telephone Number : 661-874-4050
Fax Number : 661-942-3500
Authorized Official
Title or Position : CEO
Name : MARY CUMMINGS
Credential :
Telephone Number : 661-466-3895
Provider Enumeration Date : 09/16/2011
Last Update Date : 05/21/2025

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Directions to “BARTZ-ALTADONNA COMMUNITY HEALTH CENTER ” Practice Location

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