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108 Frizzell Street Potosi MO 63664 | |
(573) 438-8500 | |
(573) 438-8787 |
Full Name | |
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Speciality | Clinic/Center |
Location | 108 Frizzell Street, Potosi, Missouri |
Authorized Official Name and Position | Debra A Pratt (CFO) |
Authorized Official Contact | 5734385451 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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108 Frizzell Street Potosi MO 63664 Ph: (573) 438-8500 | 108 Frizzell Street Potosi MO 63664 Ph: (573) 438-8500 |
NPI Number | 1467424788 |
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Provider Enumeration Date | 02/02/2006 |
Last Update Date | 08/27/2020 |
Medicare PECOS PAC ID | 3476456880 |
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Medicare Enrollment ID | O20071115000463 |
Identifier | Type | State | Issuer |
---|---|---|---|
1467424788 | NPI | - | NPPES |
598658003 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Dr. Gregory K. Terpstra D.o., Family Practice, L.l.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 612 E High St Ste 210, Potosi, MO 63664 Phone: 573-438-3660 Fax: 573-438-1140 | |
Great Mines Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: #1 Southtowne Drive, Potosi, MO 63664 Phone: 573-438-9355 Fax: 573-438-7892 | |