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324 S Hudson St Buckner MO 64016-8142 | |
(877) 344-3572 | |
(866) 228-4492 |
Full Name | |
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Speciality | Clinic/Center |
Location | 324 S Hudson St, Buckner, Missouri |
Authorized Official Name and Position | Toniann Richard (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 6602592440 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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825 S Business Highway 13 Lexington MO 64067-1515 Ph: () - | 324 S Hudson St Buckner MO 64016-8142 Ph: (877) 344-3572 |
NPI Number | 1174992374 |
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Provider Enumeration Date | 09/17/2015 |
Last Update Date | 05/10/2024 |
Medicare PECOS PAC ID | 6800034679 |
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Medicare Enrollment ID | O20151110001103 |
Identifier | Type | State | Issuer |
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1174992374 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |