| Massac Memorial Integrated Care Clinic | |
|
510 W 10th St Metropolis IL 62960-1562 | |
| (618) 524-8381 | |
| Not Available |
| Full Name | Massac Memorial Integrated Care Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 510 W 10th St, Metropolis, Illinois |
| Authorized Official Name and Position | Lynn Ann Goines (CFO) |
| Authorized Official Contact | 6185242176 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Massac Memorial Integrated Care Clinic Po Box 850 Metropolis IL 62960-0850 Ph: (618) 524-8381 | Massac Memorial Integrated Care Clinic 510 W 10th St Metropolis IL 62960-1562 Ph: (618) 524-8381 |
| NPI Number | 1356968275 |
|---|---|
| Provider Enumeration Date | 06/26/2020 |
| Last Update Date | 06/26/2020 |
| Medicare PECOS PAC ID | 3072422799 |
|---|---|
| Medicare Enrollment ID | O20200722001392 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356968275 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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