| Great Mines Health Center | |
|
608 Pine St Ofc 2 Farmington MO 63640-3020 | |
| (573) 438-9355 | |
| Not Available |
| Full Name | Great Mines Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 608 Pine St Ofc 2, Farmington, Missouri |
| Authorized Official Name and Position | Gregory A Roeback (CEO) |
| Authorized Official Contact | 5734388359 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Mines Health Center Po Box 761 Potosi MO 63664-0761 Ph: (573) 438-9355 | Great Mines Health Center 608 Pine St Ofc 2 Farmington MO 63640-3020 Ph: (573) 438-9355 |
| NPI Number | 1073188462 |
|---|---|
| Provider Enumeration Date | 05/26/2021 |
| Last Update Date | 05/26/2021 |
| Medicare PECOS PAC ID | 3072598143 |
|---|---|
| Medicare Enrollment ID | O20220808001840 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073188462 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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