Full Name | |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 106 Highway West, Eminence, Missouri |
Authorized Official Name and Position | Amy D Ledbetter (DIRECTOR OF OPERATIONS) |
Authorized Official Contact | 5736514488 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Hwy 106 West Eminence MO 65466 Ph: (573) 226-5216 | 106 Highway West Eminence MO 65466 Ph: (573) 226-5216 |
NPI Number | 1477728244 |
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Provider Enumeration Date | 04/23/2008 |
Last Update Date | 04/23/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1477728244 | NPI | - | NPPES |
598235703 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |