| Grand River Medical Center | |
|
815 E. Broadway Street Brunswick MO 65236-1468 | |
| (660) 886-7431 | |
| (660) 831-3328 |
| Full Name | Grand River Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 815 E. Broadway Street, Brunswick, Missouri |
| Authorized Official Name and Position | Nancy Harris (CFO/COO) |
| Authorized Official Contact | 6608867431 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grand River Medical Center 2305 South 65 Highway Marshall MO 65340-3702 Ph: (660) 548-3161 | Grand River Medical Center 815 E. Broadway Street Brunswick MO 65236-1468 Ph: (660) 886-7431 |
| NPI Number | 1922032549 |
|---|---|
| Provider Enumeration Date | 07/10/2006 |
| Last Update Date | 03/05/2024 |
| Medicare PECOS PAC ID | 2567351570 |
|---|---|
| Medicare Enrollment ID | O20080104000590 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922032549 | NPI | - | NPPES |
| 508292604 | Medicaid | MO | |
| 598917607 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 598917607 (Missouri) | Primary |
Jefferson Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 807 E Broadway St, Brunswick, MO 65236 Phone: 660-542-1695 |