Full Name | |
---|---|
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 701 N Oak St, Stover, Missouri |
Authorized Official Name and Position | Michael Waller (CEO) |
Authorized Official Contact | 6608264774 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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821 Westwood Dr Sedalia MO 65301-2102 Ph: (660) 826-4474 | 701 N Oak St Stover MO 65078-0842 Ph: (573) 377-4295 |
NPI Number | 1952655862 |
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Provider Enumeration Date | 10/30/2012 |
Last Update Date | 02/21/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952655862 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |