| Family Walk-in Clinic Of Mtn. Grove, Inc. | |
|
205 W 3rd St Ste 3 Mountain Grove MO 65711-1600 | |
| (417) 926-3743 | |
| (417) 926-7625 |
| Full Name | Family Walk-in Clinic Of Mtn. Grove, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 205 W 3rd St Ste 3, Mountain Grove, Missouri |
| Authorized Official Name and Position | Kenneth H Dugan (VICE-PRESIDENT) |
| Authorized Official Contact | 4179263743 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Walk-in Clinic Of Mtn. Grove, Inc. 205 W 3rd St Ste 3 Mountain Grove MO 65711-1600 Ph: (417) 926-3743 | Family Walk-in Clinic Of Mtn. Grove, Inc. 205 W 3rd St Ste 3 Mountain Grove MO 65711-1600 Ph: (417) 926-3743 |
| NPI Number | 1083705529 |
|---|---|
| Provider Enumeration Date | 09/28/2006 |
| Last Update Date | 11/12/2014 |
| Medicare PECOS PAC ID | 1052229622 |
|---|---|
| Medicare Enrollment ID | O20021022000023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083705529 | NPI | - | NPPES |
| 263939 | Other | MO | RIVERBEND |
| 596020800 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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