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20363 Lane Of Champions Warsaw MO 65355-6463 | |
(660) 438-7120 | |
(888) 979-8868 |
Full Name | |
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Speciality | Clinic/Center |
Location | 20363 Lane Of Champions, Warsaw, Missouri |
Authorized Official Name and Position | Michael Waller (CEO) |
Authorized Official Contact | 6604387120 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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821 Westwood Dr Sedalia MO 65301-2102 Ph: (660) 826-4774 | 20363 Lane Of Champions Warsaw MO 65355-6463 Ph: (660) 438-7120 |
NPI Number | 1629797196 |
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Provider Enumeration Date | 08/26/2022 |
Last Update Date | 02/21/2024 |
Medicare PECOS PAC ID | 8224926092 |
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Medicare Enrollment ID | O20221118000803 |
Identifier | Type | State | Issuer |
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1629797196 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Regional Health Care Clinic, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1620 E Main Street, Warsaw, MO 65355 Phone: 660-438-6135 Fax: 660-438-3053 |