| Holden Family Care, Llc | |
|
612 E 10th St Holden MO 64040-9421 | |
| (816) 732-6010 | |
| (816) 732-6011 |
| Full Name | Holden Family Care, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 612 E 10th St, Holden, Missouri |
| Authorized Official Name and Position | Carol Jean Jackson (OFFICE MANAGER) |
| Authorized Official Contact | 8167326010 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Holden Family Care, Llc 612 E 10th St Holden MO 64040-9421 Ph: (816) 732-6010 | Holden Family Care, Llc 612 E 10th St Holden MO 64040-9421 Ph: (816) 732-6010 |
| NPI Number | 1205154606 |
|---|---|
| Provider Enumeration Date | 05/10/2010 |
| Last Update Date | 04/10/2015 |
| Medicare PECOS PAC ID | 7113043001 |
|---|---|
| Medicare Enrollment ID | O20101209000237 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205154606 | NPI | - | NPPES |
| 1205154606 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 076670 (Missouri) | Primary |
| 363L00000X | Nurse Practitioner | 076670 (Missouri) | Secondary |
Holden Family Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 807 W 2nd St, Holden, MO 64040 Phone: 816-850-3612 Fax: 816-850-3982 |