Lake Regional Clinic - Laurie | |
156 Missouri Boulevard Suite B Laurie MO 65038-4933 | |
(573) 374-5263 | |
(573) 374-4933 |
Full Name | Lake Regional Clinic - Laurie |
---|---|
Speciality | Clinic/Center |
Location | 156 Missouri Boulevard, Laurie, 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 |
---|---|
Lake Regional Clinic - Laurie Po Box 801661 Kansas City MO 64180-1661 Ph: (573) 348-8000 | Lake Regional Clinic - Laurie 156 Missouri Boulevard Suite B Laurie MO 65038-4933 Ph: (573) 374-5263 |
NPI Number | 1427162254 |
---|---|
Provider Enumeration Date | 08/18/2006 |
Last Update Date | 10/13/2023 |
Medicare PECOS PAC ID | 9133026776 |
---|---|
Medicare Enrollment ID | O20140428000494 |
Identifier | Type | State | Issuer |
---|---|---|---|
1427162254 | NPI | - | NPPES |
594949901 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |