| Shelbina Family Practice | |
|
400 S Center St Shelbina MO 63468-1404 | |
| (573) 588-4131 | |
| (573) 588-4876 |
| Full Name | Shelbina Family Practice |
|---|---|
| Speciality | Clinic/Center |
| Location | 400 S Center St, Shelbina, Missouri |
| Authorized Official Name and Position | Roger J Dix (CFO) |
| Authorized Official Contact | 5732481300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shelbina Family Practice 6000 Hospital Drive Hannibal MO 63401-0551 Ph: (573) 248-1300 | Shelbina Family Practice 400 S Center St Shelbina MO 63468-1404 Ph: (573) 588-4131 |
| NPI Number | 1174542682 |
|---|---|
| Provider Enumeration Date | 07/18/2006 |
| Last Update Date | 10/02/2014 |
| Medicare PECOS PAC ID | 1254236300 |
|---|---|
| Medicare Enrollment ID | O20080118000489 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174542682 | NPI | - | NPPES |
| 598949808 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Moberly Medical Clinics Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 136 Shelby Plaza Rd, Shelbina, MO 63468 Phone: 573-588-1111 Fax: 573-588-1114 |