| Jordan Valley Community Health Center | |
|
649 E Elm St Republic MO 65738-1505 | |
| (417) 851-1551 | |
| Not Available |
| Full Name | Jordan Valley Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 649 E Elm St, Republic, Missouri |
| Authorized Official Name and Position | Matthew Stinson (CEO) |
| Authorized Official Contact | 4178310150 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jordan Valley Community Health Center 440 E Tampa St Springfield MO 65806-1131 Ph: (417) 831-0150 | Jordan Valley Community Health Center 649 E Elm St Republic MO 65738-1505 Ph: (417) 851-1551 |
| NPI Number | 1073939849 |
|---|---|
| Provider Enumeration Date | 03/17/2014 |
| Last Update Date | 07/30/2024 |
| Medicare PECOS PAC ID | 5395653562 |
|---|---|
| Medicare Enrollment ID | O20140430001350 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073939849 | NPI | - | NPPES |
| 500015253 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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Jordan Valley Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 649 E Elm St, Republic, MO 65738 Phone: 417-851-1565 | |
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