| |
1420 S Business 61 Unit Fde Bowling Green MO 63334-5230 | |
(573) 324-5562 | |
Not Available |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 1420 S Business 61 Unit Fde, Bowling Green, Missouri |
Authorized Official Name and Position | Annmary Tran (CFO) |
Authorized Official Contact | 5737545531 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
2305 Georgia St Louisiana MO 63353-2559 Ph: (573) 754-5531 | 1420 S Business 61 Unit Fde Bowling Green MO 63334-5230 Ph: (573) 324-5562 |
NPI Number | 1134633456 |
---|---|
Provider Enumeration Date | 11/22/2017 |
Last Update Date | 11/22/2017 |
Medicare PECOS PAC ID | 8123015518 |
---|---|
Medicare Enrollment ID | O20180227000146 |
Identifier | Type | State | Issuer |
---|---|---|---|
1134633456 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (Missouri) | Primary |
Bgmg Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 905 Highway 161, Bowling Green, MO 63334 Phone: 573-324-3333 Fax: 573-324-3334 | |
Naman Ghazal Albar Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 214 W Church St, Bowling Green, MO 63334 Phone: 573-324-5300 | |