| |
530 Arduser Dr Osceola MO 64776-6284 | |
(417) 646-8332 | |
(417) 646-8159 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
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) 646-8332 | 530 Arduser Dr Osceola MO 64776-6284 Ph: (417) 646-8332 |
NPI Number | 1972551943 |
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Provider Enumeration Date | 05/04/2006 |
Last Update Date | 08/29/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1972551943 | NPI | - | NPPES |
597951300 | Medicaid | MD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | R2903 (Missouri) | Secondary |
261QR1300X | Clinic/center - Rural Health | 96-21 (Missouri) | Primary |