| Mosaic Specialty Care - West | |
|
2016 S Main St Maryville MO 64468-2655 | |
| (660) 562-2525 | |
| (660) 526-4303 |
| Full Name | Mosaic Specialty Care - West |
|---|---|
| Speciality | Clinic/Center |
| Location | 2016 S Main St, Maryville, Missouri |
| Authorized Official Name and Position | Dwight R Carvell (DIRECTOR OF REIMBURSEMENT) |
| Authorized Official Contact | 8162730473 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mosaic Specialty Care - West 2016 S Main St Maryville MO 64468-2655 Ph: (660) 562-2525 | Mosaic Specialty Care - West 2016 S Main St Maryville MO 64468-2655 Ph: (660) 562-2525 |
| NPI Number | 1821562265 |
|---|---|
| Provider Enumeration Date | 01/18/2019 |
| Last Update Date | 03/01/2019 |
| Medicare PECOS PAC ID | 3678813896 |
|---|---|
| Medicare Enrollment ID | O20190416000538 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821562265 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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