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412 W Broadwater Rd Malden MO 63863-1358 | |
(573) 990-1002 | |
(573) 990-1284 |
Full Name | |
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Speciality | Clinic/Center |
Location | 412 W Broadwater Rd, Malden, Missouri |
Authorized Official Name and Position | Jason M Schrumpf (CEO) |
Authorized Official Contact | 5734727600 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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412 W Broadwater Rd Malden MO 63863-1358 Ph: (573) 990-1002 | 412 W Broadwater Rd Malden MO 63863-1358 Ph: (573) 990-1002 |
NPI Number | 1760241939 |
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Provider Enumeration Date | 03/18/2024 |
Last Update Date | 03/26/2024 |
Medicare PECOS PAC ID | 1355252891 |
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Medicare Enrollment ID | O20241118000193 |
Identifier | Type | State | Issuer |
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1760241939 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Mcpherson Medical & Diagnostic, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1207 N Douglass St, Malden, MO 63863 Phone: 573-276-3884 Fax: 573-276-3885 | |