| |
1207 N One Mile Rd, Dexter, MO 63841-1041 | |
(573) 624-4584 | |
(573) 624-4585 |
Full Name | |
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Type | Facility |
Speciality | Durable Medical Equipment & Medical Supplies |
Location | 1207 N One Mile Rd, Dexter, Missouri |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1932263134 | NPI | - | NPPES |
036051996 | Medicaid | IL | |
203169800 | Medicaid | MO |
Mailing Address | Practice Location Address |
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1200 W Deyoung St, P.o. Box 1178, Marion, IL 62959-4437 Ph: (618) 993-5686 | 1207 N One Mile Rd, Dexter, MO 63841-1041 Ph: (573) 624-4584 |