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815 Elm St Frederick Ball Public Housing Quincy IL 62301-2365 | |
| (573) 603-1460 | |
| (573) 603-1462 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 815 Elm St, Quincy, Illinois |
| Authorized Official Name and Position | Mark Conover (COO) |
| Authorized Official Contact | 6606651962 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
900 E Laharpe St Kirksville MO 63501-4520 Ph: (660) 665-1962 | 815 Elm St Frederick Ball Public Housing Quincy IL 62301-2365 Ph: (573) 603-1460 |
| NPI Number | 1184082380 |
|---|---|
| Provider Enumeration Date | 02/02/2016 |
| Last Update Date | 07/29/2020 |
| Certification Date | 07/29/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184082380 | NPI | - | NPPES |
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