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521 E Main St Mt Sterling IL 62353-1378 | |
(217) 223-8400 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 521 E Main St, Mt Sterling, Illinois |
Authorized Official Name and Position | Timothy A Moore (VP FINANCE / CAO) |
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 | 521 E Main St Mt Sterling IL 62353-1378 Ph: (217) 223-8400 |
NPI Number | 1407449259 |
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Provider Enumeration Date | 02/12/2021 |
Last Update Date | 07/11/2022 |
Medicare PECOS PAC ID | 3072422534 |
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Medicare Enrollment ID | O20210507001822 |
Identifier | Type | State | Issuer |
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1407449259 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |