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725 Cleveland St Paris MO 65275-1119 | |
(573) 603-1460 | |
(573) 603-1462 |
Full Name | |
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Speciality | Clinic/Center |
Location | 725 Cleveland St, Paris, Missouri |
Authorized Official Name and Position | Mark Conover (CHIEF REVENUE OFFICER) |
Authorized Official Contact | 6606651962 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1601 Old South River Rd Saint Charles MO 63303-4120 Ph: (636) 224-1210 | 725 Cleveland St Paris MO 65275-1119 Ph: (573) 603-1460 |
NPI Number | 1770086316 |
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Provider Enumeration Date | 03/09/2018 |
Last Update Date | 07/29/2022 |
Medicare PECOS PAC ID | 0244256246 |
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Medicare Enrollment ID | O20200114003425 |
Identifier | Type | State | Issuer |
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1770086316 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
The Sutherland Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 221 N Main St, Paris, MO 65275 Phone: 660-327-6416 Fax: 660-327-6217 |