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141 Communication Dr Hannibal MO 63401-3670 | |
(573) 795-7342 | |
(573) 248-3080 |
Full Name | |
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Speciality | Clinic/Center |
Location | 141 Communication Dr, Hannibal, Missouri |
Authorized Official Name and Position | Mark Conover (CHIEF REVENUE OFFICER) |
Authorized Official Contact | 6606651962 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1601 Old South River Rd Saint Charles MO 63303-4120 Ph: (636) 224-1210 | 141 Communication Dr Hannibal MO 63401-3670 Ph: (573) 795-7342 |
NPI Number | 1639592256 |
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Provider Enumeration Date | 02/03/2014 |
Last Update Date | 07/29/2022 |
Certification Date | 07/29/2022 |
Medicare PECOS PAC ID | 0244256246 |
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Medicare Enrollment ID | O20140709000021 |
Identifier | Type | State | Issuer |
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1639592256 | NPI | - | NPPES |
1639592256 | Medicaid | MO |
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