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1930 N Business Route 5 Unit 1a Camdenton MO 65020-2659 | |
(573) 346-5624 | |
(573) 346-1957 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1930 N Business Route 5, Camdenton, Missouri |
Authorized Official Name and Position | Kevin Mcroberts (CEO) |
Authorized Official Contact | 5733488756 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 801661 Kansas City MO 64180-1661 Ph: (573) 348-8000 | 1930 N Business Route 5 Unit 1a Camdenton MO 65020-2659 Ph: (573) 346-5624 |
NPI Number | 1437440856 |
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Provider Enumeration Date | 04/20/2011 |
Last Update Date | 10/13/2023 |
Medicare PECOS PAC ID | 9133026776 |
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Medicare Enrollment ID | O20140403001063 |
Identifier | Type | State | Issuer |
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1437440856 | NPI | - | NPPES |
1437440856 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |