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Hwy 254 & Dallas Hermitage MO 65668-0125 | |
(417) 745-2121 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | Hwy 254 & Dallas, Hermitage, Missouri |
Authorized Official Name and Position | Donald J Babb (CEO) |
Authorized Official Contact | 4173266000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 125 Hermitage MO 65668-0125 Ph: (417) 745-2121 | Hwy 254 & Dallas Hermitage MO 65668-0125 Ph: (417) 745-2121 |
NPI Number | 1043424708 |
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Provider Enumeration Date | 05/10/2007 |
Last Update Date | 09/24/2015 |
Identifier | Type | State | Issuer |
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1043424708 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |