Full Name | |
---|---|
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 300 W School St, Polo, Missouri |
Authorized Official Name and Position | Matt Younger (CEO) |
Authorized Official Contact | 8162326818 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2303 Village Dr Saint Joseph MO 64506-4954 Ph: (816) 271-8262 | 300 W School St Polo MO 64671-9341 Ph: (816) 271-8262 |
NPI Number | 1588120323 |
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Provider Enumeration Date | 02/18/2019 |
Last Update Date | 11/10/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588120323 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |