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1340 S Sam Houston Blvd Houston MO 65483-2045 | |
(417) 683-4831 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 1340 S Sam Houston Blvd, Houston, Missouri |
Authorized Official Name and Position | Jennifer Heinlein (COO) |
Authorized Official Contact | 4176834831 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 1359 Ava MO 65608-1359 Ph: (417) 683-4831 | 1340 S Sam Houston Blvd Houston MO 65483-2045 Ph: (417) 683-4831 |
NPI Number | 1326585761 |
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Provider Enumeration Date | 01/24/2017 |
Last Update Date | 01/24/2017 |
Medicare PECOS PAC ID | 3072423052 |
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Medicare Enrollment ID | O20170131002714 |
Identifier | Type | State | Issuer |
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1326585761 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Hometown Healthcare And Wellness Center, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 107 E Pine St, Houston, MO 65483 Phone: 417-967-0537 Fax: 417-967-0542 | |
Dale Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1340 S Sam Houston Blvd, Houston, MO 65483 Phone: 417-967-3755 Fax: 417-967-2630 | |