| Katy Trail - Warsaw School | |
|
20363 Lane Of Champions Warsaw MO 65355-6463 | |
| (660) 438-7120 | |
| (888) 979-8868 |
| Full Name | Katy Trail - Warsaw School |
|---|---|
| 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 |
|---|---|
| Katy Trail - Warsaw School 821 Westwood Dr Sedalia MO 65301-2102 Ph: (660) 826-4774 | Katy Trail - Warsaw School 20363 Lane Of Champions Warsaw MO 65355-6463 Ph: (660) 438-7120 |
| NPI Number | 1629797196 |
|---|---|
| Provider Enumeration Date | 08/26/2022 |
| Last Update Date | 02/21/2024 |
| Medicare PECOS PAC ID | 8224926092 |
|---|---|
| Medicare Enrollment ID | O20221118000803 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629797196 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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