| Southeast Missouri Health Network | |
|
6738 State Highway 77 Benton MO 63736-8238 | |
| (573) 313-2500 | |
| (573) 313-2505 |
| Full Name | Southeast Missouri Health Network |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 6738 State Highway 77, Benton, Missouri |
| Authorized Official Name and Position | Chris Jones (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5733132500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Missouri Health Network 6738 State Highway 77 Benton MO 63736-8238 Ph: (573) 313-2500 | Southeast Missouri Health Network 6738 State Highway 77 Benton MO 63736-8238 Ph: (573) 313-2500 |
| NPI Number | 1932108974 |
|---|---|
| Provider Enumeration Date | 07/20/2005 |
| Last Update Date | 10/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932108974 | NPI | - | NPPES |
| 406087205 | Medicaid | MO | |
| 400704003 | Medicaid | MO | |
| 500704028 | Medicaid | MO | |
| 503973901 | Medicaid | MO | |
| 406126003 | Medicaid | MO | |
| 500704010 | Medicaid | MO | |
| 500704036 | Medicaid | MO | |
| 500704051 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Comprehensive Family Health Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 142 S Winchester St, Benton, MO 63736 Phone: 573-335-1344 | |
Benton Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6724 State Highway 77, Benton, MO 63736 Phone: 573-748-7712 Fax: 573-545-4425 | |
Benton Community Care Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6468 State Highway 77, Benton, MO 63736 Phone: 573-545-3700 |