| |
530 Arduser Dr Osceola MO 64776-6284 | |
(417) 646-8157 | |
(417) 646-8159 |
Full Name | |
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Speciality | Clinic/center - Public Health, State Or Local |
Location | 530 Arduser Dr, Osceola, Missouri |
Authorized Official Name and Position | Nancy Mary Stephan (CFO/ADMINISTRATOR) |
Authorized Official Contact | 4176468157 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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530 Arduser Dr Osceola MO 64776-6284 Ph: (417) 646-8157 | 530 Arduser Dr Osceola MO 64776-6284 Ph: (417) 646-8157 |
NPI Number | 1013966654 |
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Provider Enumeration Date | 05/10/2006 |
Last Update Date | 06/15/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013966654 | NPI | - | NPPES |
511936601 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP0905X | Clinic/center - Public Health, State Or Local | 96-21 (Missouri) | Primary |