Mound City Medical Clinc | |
1303 State Street Mound City MO 64470-1717 | |
(660) 442-5464 | |
(660) 442-5927 |
Full Name | Mound City Medical Clinc |
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Speciality | Clinic/Center |
Location | 1303 State Street, Mound City, Missouri |
Authorized Official Name and Position | Matt Younger (CEO) |
Authorized Official Contact | 8162326818 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mound City Medical Clinc 1303 State Street Mound City MO 64470-1717 Ph: (660) 442-5464 | Mound City Medical Clinc 1303 State Street Mound City MO 64470-1717 Ph: (660) 442-5464 |
NPI Number | 1437270915 |
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Provider Enumeration Date | 04/03/2007 |
Last Update Date | 11/10/2021 |
Medicare PECOS PAC ID | 7113835174 |
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Medicare Enrollment ID | O20080731000504 |
Identifier | Type | State | Issuer |
---|---|---|---|
1437270915 | NPI | - | NPPES |
502111248 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Community Hospital Association Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 514 State St, Mound City, MO 64470 Phone: 660-442-3181 Fax: 660-686-2618 |