| Great Mines Health Center | |
|
508 W Pine St Farmington MO 63640-1426 | |
| (573) 664-1100 | |
| Not Available |
| Full Name | Great Mines Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 508 W Pine St, Farmington, Missouri |
| Authorized Official Name and Position | Michael L Johnson (CEO) |
| Authorized Official Contact | 5734388321 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Mines Health Center 508 W Pine St Farmington MO 63640-1426 Ph: (573) 664-1100 | Great Mines Health Center 508 W Pine St Farmington MO 63640-1426 Ph: (573) 664-1100 |
| NPI Number | 1922446384 |
|---|---|
| Provider Enumeration Date | 06/07/2013 |
| Last Update Date | 06/07/2013 |
| Medicare PECOS PAC ID | 3072598143 |
|---|---|
| Medicare Enrollment ID | O20080130000157 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922446384 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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