| Pcmh Clinic | |
|
2305 Georgia St Louisiana MO 63353-2559 | |
| (573) 754-4584 | |
| (573) 754-5280 |
| Full Name | Pcmh Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 2305 Georgia St, Louisiana, Missouri |
| Authorized Official Name and Position | Justin Selle (CEO) |
| Authorized Official Contact | 5737545531 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pcmh Clinic 2305 Georgia St Louisiana MO 63353-2559 Ph: (573) 754-4584 | Pcmh Clinic 2305 Georgia St Louisiana MO 63353-2559 Ph: (573) 754-4584 |
| NPI Number | 1538513072 |
|---|---|
| Provider Enumeration Date | 04/21/2016 |
| Last Update Date | 10/17/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538513072 | NPI | - | NPPES |
| 000011701 | Other | MO | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Pcmh Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2305 Georgia St, Louisiana, MO 63353 Phone: 573-754-4584 Fax: 573-754-5280 | |
Pike Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 211 S 3rd St, Louisiana, MO 63353 Phone: 573-754-5555 Fax: 573-754-4077 | |
Pike Medical Clinic, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 211 S 3rd St, Louisiana, MO 63353 Phone: 573-754-5555 Fax: 573-754-4077 |