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821 Us Highway 24 And 36 E Monroe City MO 63456-1470 | |
(573) 735-2506 | |
(573) 735-1083 |
Full Name | |
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Speciality | Clinic/Center |
Location | 821 Us Highway 24 And 36 E, Monroe City, Missouri |
Authorized Official Name and Position | Roger J Dix (CFO) |
Authorized Official Contact | 5732481300 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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6000 Hospital Dr Hannibal MO 63401-6887 Ph: (573) 248-1300 | 821 Us Highway 24 And 36 E Monroe City MO 63456-1470 Ph: (573) 735-2506 |
NPI Number | 1912926429 |
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Provider Enumeration Date | 07/18/2006 |
Last Update Date | 11/20/2014 |
Medicare PECOS PAC ID | 1254236300 |
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Medicare Enrollment ID | O20080118000468 |
Identifier | Type | State | Issuer |
---|---|---|---|
1912926429 | NPI | - | NPPES |
598962108 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |