| Cuc-llc | |
|
619 N Providence Rd Columbia MO 65203-4355 | |
| (573) 234-1070 | |
| (573) 818-1342 |
| Full Name | Cuc-llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 619 N Providence Rd, Columbia, Missouri |
| Authorized Official Name and Position | Jonathan Wayne Morris (OWNER) |
| Authorized Official Contact | 5732341070 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cuc-llc 619 N Providence Rd Columbia MO 65203-4355 Ph: (573) 234-1070 | Cuc-llc 619 N Providence Rd Columbia MO 65203-4355 Ph: (573) 234-1070 |
| NPI Number | 1366008682 |
|---|---|
| Provider Enumeration Date | 05/13/2019 |
| Last Update Date | 05/13/2019 |
| Medicare PECOS PAC ID | 7517296957 |
|---|---|
| Medicare Enrollment ID | O20190910000965 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366008682 | NPI | - | NPPES |
| 2012020312 | Other | MO | MISSOURI STATE BOARD OF REGISTRATION FOR THE HEALING ARTS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Primary |
| Provider Name | Jonathan W Morris |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134368962 PECOS PAC ID: 5092966531 Enrollment ID: I20121110000173 |
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