Full Name | |
---|---|
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 860 Lynn St, Lebanon, Missouri |
Authorized Official Name and Position | Jo Anne Thompson (DIRECTOR OF FINANCE) |
Authorized Official Contact | 4178310150 |
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 | 860 Lynn St Lebanon MO 65536-3810 Ph: (417) 344-0062 |
NPI Number | 1720566805 |
---|---|
Provider Enumeration Date | 08/01/2018 |
Last Update Date | 12/02/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1720566805 | NPI | - | NPPES |
PENDING | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
3336C0002X | Pharmacy - Clinic Pharmacy | 2017013552 (Missouri) | Secondary |
Philip W Caster Md And John P Caster Md Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 732 S Madison Ave, Lebanon, MO 65536 Phone: 417-532-9161 Fax: 417-532-8360 | |
Family Health Associates, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 341 Hospital Dr, Lebanon, MO 65536 Phone: 417-532-7850 Fax: 417-532-2451 | |
Advocates For A Healthy Community, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 Hoover St, Lebanon, MO 65536 Phone: 417-334-8337 Fax: 417-532-2067 | |
Advocates For A Healthy Community, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2020 Evergreen Pkwy, Lebanon, MO 65536 Phone: 417-334-8337 Fax: 417-832-8275 |