| Macoupin Family Practice Centers, Llp | |
|
115 N Poplar St Mount Olive IL 62069-1613 | |
| (217) 999-4751 | |
| Not Available |
| Full Name | Macoupin Family Practice Centers, Llp |
|---|---|
| Speciality | Clinic/Center |
| Location | 115 N Poplar St, Mount Olive, Illinois |
| Authorized Official Name and Position | Bruce F Weber (DIRECTOR) |
| Authorized Official Contact | 2179994751 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Macoupin Family Practice Centers, Llp 115 N Poplar St Mount Olive IL 62069-1613 Ph: (217) 999-4751 | Macoupin Family Practice Centers, Llp 115 N Poplar St Mount Olive IL 62069-1613 Ph: (217) 999-4751 |
| NPI Number | 1881894533 |
|---|---|
| Provider Enumeration Date | 07/20/2007 |
| Last Update Date | 06/09/2023 |
| Medicare PECOS PAC ID | 2365350253 |
|---|---|
| Medicare Enrollment ID | O20030114000003 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881894533 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Macoupin Family Practice Centers, Llp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 115 N Poplar St, Mount Olive, IL 62069 Phone: 217-999-4751 Fax: 217-999-2317 |