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101 Hospital Dr Osceola MO 64776-9547 | |
(417) 646-8158 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 101 Hospital Dr, Osceola, Missouri |
Authorized Official Name and Position | Teresa Porter (CREDENTIALING MANAGER) |
Authorized Official Contact | 6608908186 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1800 Community Clinton MO 64735-8804 Ph: () - | 101 Hospital Dr Osceola MO 64776-9547 Ph: (417) 646-8158 |
NPI Number | 1699104687 |
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Provider Enumeration Date | 11/11/2013 |
Last Update Date | 03/17/2015 |
Medicare PECOS PAC ID | 1951206754 |
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Medicare Enrollment ID | O20131209001321 |
Identifier | Type | State | Issuer |
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1699104687 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |