Community Hospital-fairfax | |
100 E Cass St Rock Port MO 64482-1528 | |
(660) 744-5361 | |
(660) 744-2247 |
Full Name | Community Hospital-fairfax |
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Speciality | Clinic/Center |
Location | 100 E Cass St, Rock Port, Missouri |
Authorized Official Name and Position | Jon P Davis (CFO) |
Authorized Official Contact | 6606862320 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Community Hospital-fairfax 100 E Cass Street Rock Port MO 64482-1528 Ph: (660) 744-5361 | Community Hospital-fairfax 100 E Cass St Rock Port MO 64482-1528 Ph: (660) 744-5361 |
NPI Number | 1396741302 |
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Provider Enumeration Date | 06/23/2005 |
Last Update Date | 12/18/2020 |
Medicare PECOS PAC ID | 1557316783 |
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Medicare Enrollment ID | O20190926001338 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396741302 | NPI | - | NPPES |
505428102 | Medicaid | MO | |
29516017 | Other | MO | BCBS KANSAS CITY MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (Missouri) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |