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835 W Murray Ln Sikeston MO 63801-4056 | |
(573) 472-8808 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 835 W Murray Ln, Sikeston, Missouri |
Authorized Official Name and Position | Sara Deane (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 5733132500 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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6738 State Highway 77 Benton MO 63736-8238 Ph: (573) 313-2500 | 835 W Murray Ln Sikeston MO 63801-4056 Ph: (573) 472-8808 |
NPI Number | 1619513215 |
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Provider Enumeration Date | 11/19/2019 |
Last Update Date | 04/14/2020 |
Medicare PECOS PAC ID | 6507818044 |
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Medicare Enrollment ID | O20191125000468 |
Identifier | Type | State | Issuer |
---|---|---|---|
1619513215 | NPI | - | NPPES |
500077951 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
Managed Care Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 808 Hunter, Suite 4, Sikeston, MO 63801 Phone: 573-471-2905 | |
Missouri Delta Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1008 N Main St, Sikeston, MO 63801 Phone: 573-471-1600 Fax: 573-472-7740 | |
Missouri Delta Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 123 Smith Ave, Sikeston, MO 63801 Phone: 573-471-0200 | |
Missouri Delta Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1008 N Main St, Sikeston, MO 63801 Phone: 573-471-1600 Fax: 573-472-7740 |