| Lake Regional Clinic-lebanon | |
|
755 Cowan Drive Lebanon MO 65536 | |
| (417) 532-2805 | |
| (417) 532-2848 |
| Full Name | Lake Regional Clinic-lebanon |
|---|---|
| Speciality | Clinic/Center |
| Location | 755 Cowan Drive, Lebanon, Missouri |
| Authorized Official Name and Position | Kevin Mcroberts (CEO) |
| Authorized Official Contact | 5733488388 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Regional Clinic-lebanon Po Box 801661 Kansas City MO 64180-1661 Ph: (573) 348-8000 | Lake Regional Clinic-lebanon 755 Cowan Drive Lebanon MO 65536 Ph: (417) 532-2805 |
| NPI Number | 1386311223 |
|---|---|
| Provider Enumeration Date | 08/27/2021 |
| Last Update Date | 10/12/2023 |
| Medicare PECOS PAC ID | 9133026776 |
|---|---|
| Medicare Enrollment ID | O20210922000428 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386311223 | NPI | - | NPPES |
| 590107490 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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Family Health Associates, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 341 Hospital Dr, Lebanon, MO 65536 Phone: 417-532-7850 Fax: 417-532-2451 | |
Cox Health Center Lebanon Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 510 Highway 32, Lebanon, MO 65536 Phone: 417-269-2278 Fax: 417-269-2274 | |
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