| |
116 Mccall St Wheaton MO 64874-7701 | |
(417) 782-6200 | |
(417) 782-6210 |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 116 Mccall St, Wheaton, Missouri |
Authorized Official Name and Position | Donald M Mcbride (CEO) |
Authorized Official Contact | 4174519450 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 758 Neosho MO 64850-0758 Ph: (417) 451-9450 | 116 Mccall St Wheaton MO 64874-7701 Ph: (417) 782-6200 |
NPI Number | 1689331548 |
---|---|
Provider Enumeration Date | 11/26/2021 |
Last Update Date | 09/09/2024 |
Medicare PECOS PAC ID | 8123918257 |
---|---|
Medicare Enrollment ID | O20220105000867 |
Identifier | Type | State | Issuer |
---|---|---|---|
1689331548 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |