| Coxhealth Center Mountain Grove | |
|
1602a N Main St Mountain Grove MO 65711-1010 | |
| (417) 269-2350 | |
| (417) 269-2356 |
| Full Name | Coxhealth Center Mountain Grove |
|---|---|
| Speciality | Clinic/Center |
| Location | 1602a N Main St, Mountain Grove, Missouri |
| Authorized Official Name and Position | Jacob Mcway (SR VP & CFO) |
| Authorized Official Contact | 4172698811 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coxhealth Center Mountain Grove Po Box 505673 Saint Louis MO 63150-5673 Ph: (417) 730-6430 | Coxhealth Center Mountain Grove 1602a N Main St Mountain Grove MO 65711-1010 Ph: (417) 269-2350 |
| NPI Number | 1871539023 |
|---|---|
| Provider Enumeration Date | 06/22/2006 |
| Last Update Date | 09/27/2024 |
| Medicare PECOS PAC ID | 1254248917 |
|---|---|
| Medicare Enrollment ID | O20041111000502 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871539023 | NPI | - | NPPES |
| 595957903 | Medicaid | MO | |
| 505957902 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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