Full Name | |
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Speciality | Clinic/Center |
Location | 92 Main St, Cassville, Missouri |
Authorized Official Name and Position | Robert Cavagnol (CHIEF PHYSICIAN OFFICER) |
Authorized Official Contact | 4178202705 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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645 Maryville Centre Dr Fl 3 Saint Louis MO 63141-5855 Ph: (417) 820-7133 | 92 Main St Cassville MO 65625 Ph: (417) 847-5225 |
NPI Number | 1497887848 |
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Provider Enumeration Date | 03/12/2007 |
Last Update Date | 12/04/2018 |
Medicare PECOS PAC ID | 7416865845 |
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Medicare Enrollment ID | O20090602000447 |
Identifier | Type | State | Issuer |
---|---|---|---|
1497887848 | NPI | - | NPPES |
595386806 | Medicaid | MO |
Barry County Health Department Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 65 Main St, Cassville, MO 65625 Phone: 417-847-2114 Fax: 417-847-2116 |