Full Name | |
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Speciality | Clinic/Center |
Location | 1501 Wall St, Beardstown, Illinois |
Authorized Official Name and Position | Teresa Armstrong (DIRECTOR) |
Authorized Official Contact | 2174523057 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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331 S Main St Virginia IL 62691-1571 Ph: (217) 452-3057 | 1501 Wall St Beardstown IL 62618 Ph: (217) 323-2242 |
NPI Number | 1942439310 |
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Provider Enumeration Date | 07/07/2009 |
Last Update Date | 09/19/2023 |
Medicare PECOS PAC ID | 5395745137 |
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Medicare Enrollment ID | O20140729002328 |
Identifier | Type | State | Issuer |
---|---|---|---|
1942439310 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Memorial Physician Services Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8460 Saint Lukes Dr, Beardstown, IL 62618 Phone: 217-544-0306 Fax: 217-323-1739 | |
Susan Burge Do Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 111 S State St, Beardstown, IL 62618 Phone: 217-323-9703 Fax: 217-323-9706 | |