| Samuel U. Rodgers Health Center Clay County Family Medicine & Dental | |
|
800 Haines Drive Liberty MO 64068 | |
| (816) 792-1575 | |
| (816) 889-1803 |
| Full Name | Samuel U. Rodgers Health Center Clay County Family Medicine & Dental |
|---|---|
| Speciality | Clinic/Center |
| Location | 800 Haines Drive, Liberty, Missouri |
| Authorized Official Name and Position | Robert Theis (ACTING CEO) |
| Authorized Official Contact | 8164744920 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Samuel U. Rodgers Health Center Clay County Family Medicine & Dental 825 Euclid Ave Kansas City MO 64124-2323 Ph: (816) 474-4920 | Samuel U. Rodgers Health Center Clay County Family Medicine & Dental 800 Haines Drive Liberty MO 64068 Ph: (816) 792-1575 |
| NPI Number | 1982931655 |
|---|---|
| Provider Enumeration Date | 11/17/2009 |
| Last Update Date | 06/11/2019 |
| Medicare PECOS PAC ID | 9739092826 |
|---|---|
| Medicare Enrollment ID | O20101015001306 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982931655 | NPI | - | NPPES |
| 504119702 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Missouri) | Primary |
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