| |
307 S Broadway Salisbury MO 65281-1037 | |
(660) 388-6950 | |
(660) 388-6935 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 307 S Broadway, Salisbury, Missouri |
Authorized Official Name and Position | Teresa L Porter (CREDENTIALING MANAGER) |
Authorized Official Contact | 6608908156 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1001 W Worley St Columbia MO 65203-2037 Ph: (573) 886-6741 | 307 S Broadway Salisbury MO 65281-1037 Ph: (660) 388-6950 |
NPI Number | 1245479526 |
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Provider Enumeration Date | 02/11/2009 |
Last Update Date | 07/04/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1245479526 | NPI | - | NPPES |
1245479526 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |