| |
314 E Main St Portageville MO 63873-1616 | |
(573) 379-3777 | |
(573) 379-9331 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 314 E Main St, Portageville, Missouri |
Authorized Official Name and Position | Mark R Davis (CEO) |
Authorized Official Contact | 5733593612 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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314 E Main St Portageville MO 63873-1616 Ph: (573) 379-3777 | 314 E Main St Portageville MO 63873-1616 Ph: (573) 379-3777 |
NPI Number | 1699873372 |
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Provider Enumeration Date | 09/20/2006 |
Last Update Date | 05/12/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1699873372 | NPI | - | NPPES |
596948109 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
A Plus Family Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 203 E 3rd St, Portageville, MO 63873 Phone: 573-379-2100 Fax: 573-379-2101 |