| Sgoh Acquisition, Inc. | |
|
104 E Main St Anderson MO 64831-4103 | |
| (417) 845-6984 | |
| Not Available |
| Full Name | Sgoh Acquisition, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 104 E Main St, Anderson, Missouri |
| Authorized Official Name and Position | Paul Taylor (CEO) |
| Authorized Official Contact | 4178374090 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sgoh Acquisition, Inc. 104 E Main St Anderson MO 64831-4103 Ph: (417) 845-6984 | Sgoh Acquisition, Inc. 104 E Main St Anderson MO 64831-4103 Ph: (417) 845-6984 |
| NPI Number | 1063969665 |
|---|---|
| Provider Enumeration Date | 09/01/2016 |
| Last Update Date | 11/17/2017 |
| Medicare PECOS PAC ID | 5092616276 |
|---|---|
| Medicare Enrollment ID | O20170207000588 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063969665 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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