| Ozarks Healthcare Thayer | |
|
1375 Nettleton Avenue Thayer MO 65791 | |
| (417) 264-7136 | |
| (417) 264-7122 |
| Full Name | Ozarks Healthcare Thayer |
|---|---|
| Speciality | Clinic/Center |
| Location | 1375 Nettleton Avenue, Thayer, Missouri |
| Authorized Official Name and Position | Thomas Keller (CEO/PRESIDENT) |
| Authorized Official Contact | 4172569111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ozarks Healthcare Thayer 1375 Nettleton Ave Thayer MO 65791-8740 Ph: (417) 264-7136 | Ozarks Healthcare Thayer 1375 Nettleton Avenue Thayer MO 65791 Ph: (417) 264-7136 |
| NPI Number | 1730215195 |
|---|---|
| Provider Enumeration Date | 02/27/2007 |
| Last Update Date | 11/13/2020 |
| Medicare PECOS PAC ID | 3870491863 |
|---|---|
| Medicare Enrollment ID | O20071217000346 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730215195 | NPI | - | NPPES |
| 126733729 | Medicaid | AR | |
| 597843309 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 17447 (Missouri) | Primary |
Southern Missouri Community Health Center Thayer Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: Rr 3 Box 3707, Thayer, MO 65791 Phone: 417-264-2990 Fax: 417-264-2993 | |
Southern Missouri Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 E Walnut St, Thayer, MO 65791 Phone: 417-255-8464 Fax: 417-255-9732 | |
Southern Missouri Community Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 365 E Walnut St, Thayer, MO 65791 Phone: 417-255-8464 Fax: 417-255-9732 |