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316 West 40 Hwy Odessa MO 64076-9612 | |
(816) 633-5774 | |
(816) 633-5936 |
Full Name | |
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Speciality | Clinic/Center |
Location | 316 West 40 Hwy, Odessa, Missouri |
Authorized Official Name and Position | Darrel Box (CEO LRHC) |
Authorized Official Contact | 6602596852 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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316 West 40 Hwy Odessa MO 64076-9612 Ph: (816) 633-5774 | 316 West 40 Hwy Odessa MO 64076-9612 Ph: (816) 633-5774 |
NPI Number | 1003872185 |
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Provider Enumeration Date | 04/26/2006 |
Last Update Date | 01/06/2022 |
Medicare PECOS PAC ID | 0941119150 |
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Medicare Enrollment ID | O20070912000596 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003872185 | NPI | - | NPPES |
595985805 | Medicaid | MO | |
540568508 | Medicaid | MO | |
010568509 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Compass Health, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1278 W Us Highway 40, Odessa, MO 64076 Phone: 816-633-5921 | |
Odessa Eye Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 N 2nd St Ste C, Odessa, MO 64076 Phone: 816-230-5321 Fax: 816-565-2288 | |