| Cole Camp Clinic | |
|
1201 E Main Street Cole Camp MO 65325-1256 | |
| (660) 668-4411 | |
| (660) 668-4861 |
| Full Name | Cole Camp Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1201 E Main Street, Cole Camp, Missouri |
| Authorized Official Name and Position | Steven Davis (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 6608297790 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cole Camp Clinic Po Box 801128 Kansas City MO 64180-1128 Ph: (660) 668-4411 | Cole Camp Clinic 1201 E Main Street Cole Camp MO 65325-1256 Ph: (660) 668-4411 |
| NPI Number | 1497705313 |
|---|---|
| Provider Enumeration Date | 05/11/2006 |
| Last Update Date | 05/22/2023 |
| Medicare PECOS PAC ID | 6103714126 |
|---|---|
| Medicare Enrollment ID | O20220518001770 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497705313 | NPI | - | NPPES |
| E69550 | Other | MO | MERCY HEALTH PLANS PIN |
| 212202 | Other | MO | HEALTHLINK PIN |
| 4649395 | Other | MO | AETNA PIN |
| 507959500 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Katy Trail Community Health Cole Camp R-1 Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 500 S Keeney St, Cole Camp, MO 65325 Phone: 660-668-4427 Fax: 660-827-8992 |