Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 2550 Lusk Dr, Neosho, Missouri |
Authorized Official Name and Position | Mathew Joel Janssens (CFO) |
Authorized Official Contact | 4175562459 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
2550 Lusk Dr Neosho MO 64850-8855 Ph: (417) 451-2060 | 2550 Lusk Dr Neosho MO 64850 Ph: (417) 451-2060 |
NPI Number | 1205162732 |
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Provider Enumeration Date | 10/17/2009 |
Last Update Date | 06/22/2024 |
Medicare PECOS PAC ID | 8820139587 |
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Medicare Enrollment ID | O20100111000147 |
Identifier | Type | State | Issuer |
---|---|---|---|
1205162732 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | N/A (* (Not Available)) | Primary |
Freeman Neosho Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 336 S Jefferson St, Neosho, MO 64850 Phone: 417-455-4200 | |
Free Market Physician Hospital Services, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4040 La Questa Dr, Neosho, MO 64850 Phone: 417-283-4953 | |