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2333 Highway 17 Iberia MO 65486-9331 | |
(573) 793-6900 | |
(573) 793-6688 |
Full Name | |
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Speciality | Clinic/Center |
Location | 2333 Highway 17, Iberia, 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 | 2333 Highway 17 Iberia MO 65486-9331 Ph: (573) 793-6900 |
NPI Number | 1891018784 |
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Provider Enumeration Date | 03/05/2010 |
Last Update Date | 10/13/2023 |
Medicare PECOS PAC ID | 9133026776 |
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Medicare Enrollment ID | O20140401000871 |
Identifier | Type | State | Issuer |
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1891018784 | NPI | - | NPPES |
1891018784 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |