| Comtrea | |
|
4 Hickory Ridge Rd Ste 600 Hillsboro MO 63050-5100 | |
| (636) 481-6040 | |
| (636) 677-9179 |
| Full Name | Comtrea |
|---|---|
| Speciality | Clinic/Center |
| Location | 4 Hickory Ridge Rd, Hillsboro, Missouri |
| Authorized Official Name and Position | Teresa L Porter (CREDENTIALING MANAGER) |
| Authorized Official Contact | 6364666452 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Comtrea 1800 Community Clinton MO 64735-8804 Ph: (844) 853-8937 | Comtrea 4 Hickory Ridge Rd Ste 600 Hillsboro MO 63050-5100 Ph: (636) 481-6040 |
| NPI Number | 1477800340 |
|---|---|
| Provider Enumeration Date | 08/10/2012 |
| Last Update Date | 08/23/2023 |
| Medicare PECOS PAC ID | 1951206754 |
|---|---|
| Medicare Enrollment ID | O20230914000942 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477800340 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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