Full Name | |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 100 S Main Street, Gideon, Missouri |
Authorized Official Name and Position | James Marshall (CFO) |
Authorized Official Contact | 5733593612 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 489 Hayti MO 63851-0489 Ph: () - | 100 S Main Street Gideon MO 63848 Ph: (573) 448-3800 |
NPI Number | 1124518451 |
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Provider Enumeration Date | 05/11/2018 |
Last Update Date | 07/19/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1124518451 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |