<unavail> in Mountain Grove, MO - Medicare Clinic/Center

is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Mountain Grove, Missouri. The current practice location for is 1604 C. North Main Street, Mountain Grove, Missouri. For appointments, you can reach them via phone at (417) 926-1713. The mailing address for is Po Box 1359, Ava, Missouri and phone number is (417) 683-4831.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1518342153. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (417) 926-1713.

Contact Information


	1604 C. North Main Street Mountain Grove MO 65711
	(417) 926-1713
	(417) 926-1209

Map and Direction

Primary Care Clinic Profile

Full Name
Speciality	Clinic/Center
Location	1604 C. North Main Street, Mountain Grove, Missouri
Authorized Official Name and Position	Tim Shryack (CEO)
Authorized Official Contact	4176834831
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Po Box 1359 Ava MO 65608-1359 Ph: (417) 683-4831	1604 C. North Main Street Mountain Grove MO 65711 Ph: (417) 926-1713

NPI Details:

NPI Number	1518342153
Provider Enumeration Date	07/24/2015
Last Update Date	09/02/2015

Medicare PECOS Information:

Medicare PECOS PAC ID	3072423052
Medicare Enrollment ID	O20150828000981

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1518342153	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
261QF0400X	Clinic/center - Federally Qualified Health Center (fqhc)	(* (Not Available))	Primary

Reviews and Comments

Clinic/Center in Mountain Grove, MO

Mountain Grove Medical And Laser Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 601 N Busch Ave, Mountain Grove, MO 65711 Phone: 417-926-6643 Fax: 417-926-6317
Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 205 W 3rd St Ste 3, Mountain Grove, MO 65711 Phone: 417-926-3743 Fax: 417-926-7625
Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1905 West 19th Street, Mountain Grove, MO 65711 Phone: 417-926-1770 Fax: 417-926-1785
Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1905 West 19th Street, Mountain Grove, MO 65711 Phone: 417-926-1770 Fax: 417-926-1785
Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 500 East 19th Street, Suite A, Mountain Grove, MO 65711 Phone: 417-926-6563 Fax: 417-926-5820
Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 120 W 16th St, Mountain Grove, MO 65711 Phone: 417-926-6111 Fax: 417-926-6115

- Medicare Primary Care in Mountain Grove, MO