| South Central Missouri Community Health Center | |
|
165 Park Drive St. Robert MO 65584 | |
| (573) 426-2407 | |
| Not Available |
| Full Name | South Central Missouri Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 165 Park Drive, St. Robert, Missouri |
| Authorized Official Name and Position | Elizabeth Sparks (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 5734262407 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Central Missouri Community Health Center 1081 E 18th St Rolla MO 65401-2448 Ph: (573) 426-2407 | South Central Missouri Community Health Center 165 Park Drive St. Robert MO 65584 Ph: (573) 426-2407 |
| NPI Number | 1558070102 |
|---|---|
| Provider Enumeration Date | 11/22/2022 |
| Last Update Date | 11/22/2022 |
| Medicare PECOS PAC ID | 1355513581 |
|---|---|
| Medicare Enrollment ID | O20230228001666 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558070102 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Mercy Clinic Family Medicine-st. Robert Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 608 City Route 66, St. Robert, MO 65584 Phone: 573-336-5100 Fax: 573-336-3118 |