| Pfcc West | |
|
1508 Edgemont Blvd Perryville MO 63775-1231 | |
| (573) 768-3220 | |
| Not Available |
| Full Name | Pfcc West |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 1508 Edgemont Blvd, Perryville, Missouri |
| Authorized Official Name and Position | Patrick Carron (CEO) |
| Authorized Official Contact | 5735472536 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pfcc West 212 Hospital Ln Suite 101 Perryville MO 63775-1224 Ph: (573) 768-3220 | Pfcc West 1508 Edgemont Blvd Perryville MO 63775-1231 Ph: (573) 768-3220 |
| NPI Number | 1114327954 |
|---|---|
| Provider Enumeration Date | 08/29/2014 |
| Last Update Date | 09/24/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114327954 | NPI | - | NPPES |
| 1114327954 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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