| Cross Trails Medical Center | |
|
307 Gabriel St. Advance MO 63730 | |
| (573) 722-3034 | |
| (573) 722-3244 |
| Full Name | Cross Trails Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 307 Gabriel St., Advance, Missouri |
| Authorized Official Name and Position | Mona Wells (CFO) |
| Authorized Official Contact | 5733391196 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cross Trails Medical Center Po Box 39 Advance MO 63730-0039 Ph: (573) 722-3034 | Cross Trails Medical Center 307 Gabriel St. Advance MO 63730 Ph: (573) 722-3034 |
| NPI Number | 1225191752 |
|---|---|
| Provider Enumeration Date | 12/18/2006 |
| Last Update Date | 10/15/2010 |
| Medicare PECOS PAC ID | 8820902851 |
|---|---|
| Medicare Enrollment ID | O20100908000602 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225191752 | NPI | - | NPPES |
| 508082823 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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