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100 Medical Dr Ste A1g1h Hannibal MO 63401-6877 | |
(573) 231-3900 | |
(573) 231-3827 |
Full Name | |
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Speciality | Clinic/Center |
Location | 100 Medical Dr Ste A1g1h, Hannibal, Missouri |
Authorized Official Name and Position | Brian Canfield (PRESIDENT / CEO) |
Authorized Official Contact | 2172238400 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1005 Broadway St Quincy IL 62301-2834 Ph: (217) 223-8400 | 100 Medical Dr Ste A1g1h Hannibal MO 63401-6877 Ph: (573) 231-3900 |
NPI Number | 1457062101 |
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Provider Enumeration Date | 12/13/2022 |
Last Update Date | 11/07/2023 |
Medicare PECOS PAC ID | 3072422534 |
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Medicare Enrollment ID | O20230531002462 |
Identifier | Type | State | Issuer |
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1457062101 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Marion County Health Dept. & Home Health Agency Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3105 Rt. W, Hannibal, MO 63401 Phone: 573-221-1166 Fax: 573-221-1214 | |