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504 N Sturgeon St Montgomery City MO 63361-1829 | |
(573) 564-2990 | |
(573) 564-2963 |
Full Name | |
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Speciality | Clinic/Center |
Location | 504 N Sturgeon St, Montgomery City, Missouri |
Authorized Official Name and Position | Dan Mckinney (ADMINISTRATOR) |
Authorized Official Contact | 5734862191 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 19 Hermann MO 65041-0019 Ph: (573) 486-1193 | 504 N Sturgeon St Montgomery City MO 63361-1829 Ph: (573) 564-2990 |
NPI Number | 1811062375 |
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Provider Enumeration Date | 11/21/2006 |
Last Update Date | 04/24/2009 |
Medicare PECOS PAC ID | 5496669962 |
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Medicare Enrollment ID | O20100319000341 |
Identifier | Type | State | Issuer |
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1811062375 | NPI | - | NPPES |
590420808 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
East Central Missouri Behavioral Health Services, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1225 Aguilar Dr., Montgomery City, MO 63361 Phone: 573-582-1234 Fax: 573-582-1212 | |
Healthy Choice Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 111 E 1st St, Montgomery City, MO 63361 Phone: 573-564-3214 Fax: 573-564-3216 | |