Springfield Clinic Moweaqua | |
620 N Putnam St Ste A Moweaqua IL 62550-9489 | |
(217) 768-3884 | |
Not Available |
Full Name | Springfield Clinic Moweaqua |
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Speciality | Clinic/Center |
Location | 620 N Putnam St Ste A, Moweaqua, Illinois |
Authorized Official Name and Position | Christopher Michael Cousins (VP) |
Authorized Official Contact | 2173917100 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Springfield Clinic Moweaqua Po Box 19248 Springfield IL 62794-9248 Ph: (217) 528-7541 | Springfield Clinic Moweaqua 620 N Putnam St Ste A Moweaqua IL 62550-9489 Ph: (217) 768-3884 |
NPI Number | 1548928211 |
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Provider Enumeration Date | 11/30/2021 |
Last Update Date | 12/01/2021 |
Medicare PECOS PAC ID | 0547166076 |
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Medicare Enrollment ID | O20220120002097 |
Identifier | Type | State | Issuer |
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1548928211 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Moweaqua Family Practice Center, Ltd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 620 N Putnam St, Moweaqua, IL 62550 Phone: 217-768-3884 Fax: 217-768-3811 |