| Poplar Bluff Wellness Clinic | |
|
930 N Westwood Blvd Poplar Bluff MO 63901-4242 | |
| (573) 778-1620 | |
| (573) 778-1486 |
| Full Name | Poplar Bluff Wellness Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 930 N Westwood Blvd, Poplar Bluff, Missouri |
| Authorized Official Name and Position | Paula J Mcalister (ADMINISTRATOR) |
| Authorized Official Contact | 5737781697 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Poplar Bluff Wellness Clinic 930 N Westwood Blvd Poplar Bluff MO 63901-4242 Ph: (573) 778-1620 | Poplar Bluff Wellness Clinic 930 N Westwood Blvd Poplar Bluff MO 63901-4242 Ph: (573) 778-1620 |
| NPI Number | 1952550485 |
|---|---|
| Provider Enumeration Date | 09/09/2008 |
| Last Update Date | 09/09/2008 |
| Medicare PECOS PAC ID | 0446319289 |
|---|---|
| Medicare Enrollment ID | O20081107000297 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952550485 | NPI | - | NPPES |
| 164653 | Other | MO | BLUE CROSS BLUE SHIELD |
| 242613084 | Medicaid | MO | |
| 26D1003101 | Other | MO | CLIA |
| 000000E14668 | Other | MO | PREMIER BENEFITS |
| 915331 | Other | UNITED HEALTH CARE | |
| P00109903 | Other | MO | MEDICARE RAILROAD |
| 1922003276 | Other | MO | INDIVIDUAL NPI |
| 242613073 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 36720 (Missouri) | Primary |
| Provider Name | Dorothy M Munch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922003276 PECOS PAC ID: 3274574181 Enrollment ID: I20050520000001 |
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