Full Name | |
---|---|
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 33 Gage Dr, Hollister, Missouri |
Authorized Official Name and Position | Kenneth Brooks Miller (CEO) |
Authorized Official Contact | 4178511551 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
440 E Tampa St Springfield MO 65806-1131 Ph: (417) 851-1551 | 33 Gage Dr Hollister MO 65672-5862 Ph: (417) 334-8300 |
NPI Number | 1922439405 |
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Provider Enumeration Date | 12/09/2013 |
Last Update Date | 12/02/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1922439405 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Southtowne Urgent Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 180 Mall Rd, Suite H, Hollister, MO 65672 Phone: 417-336-5161 Fax: 417-336-0242 | |
Agape Primary Care Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2331 S Business Highway 65, Hollister, MO 65672 Phone: 417-339-3033 Fax: 417-339-9133 |