Full Name | |
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Speciality | Clinic/Center |
Location | 1447 Main Street, Jayton, Texas |
Authorized Official Name and Position | Michael Moorhead (CEO) |
Authorized Official Contact | 9409892875 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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821 N Broadway St Aspermont TX 79502-2029 Ph: (940) 989-3551 | 1447 Main Street Jayton TX 79528 Ph: (806) 237-3405 |
NPI Number | 1679992911 |
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Provider Enumeration Date | 04/15/2014 |
Last Update Date | 07/09/2024 |
Medicare PECOS PAC ID | 1254228919 |
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Medicare Enrollment ID | O20140707000135 |
Identifier | Type | State | Issuer |
---|---|---|---|
1679992911 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |