Full Name | |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 1312 North Highway 5, Ava, Missouri |
Authorized Official Name and Position | Stuart G. Stangeland (SENIOR VICE PRESIDENT, COO) |
Authorized Official Contact | 4178206556 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 505164 Saint Louis MO 63150-5164 Ph: (417) 820-2000 | 1312 North Highway 5 Ava MO 65608 Ph: (417) 683-4045 |
NPI Number | 1770618233 |
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Provider Enumeration Date | 02/23/2007 |
Last Update Date | 04/28/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770618233 | NPI | - | NPPES |
595879701 | Medicaid | MO |
Douglas County Health Department Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 603 Nw 12th St, Building C, Ava, MO 65608 Phone: 417-683-4174 Fax: 417-683-4111 | |