| Sullivan County Memorial Hospital Milan Family Practice | |
|
210 N Market St Milan MO 63556-1316 | |
| (660) 265-4456 | |
| Not Available |
| Full Name | Sullivan County Memorial Hospital Milan Family Practice |
|---|---|
| Speciality | Clinic/Center |
| Location | 210 N Market St, Milan, Missouri |
| Authorized Official Name and Position | Amy Michael (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 6602654212 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sullivan County Memorial Hospital Milan Family Practice 630 W 3rd St Milan MO 63556-1076 Ph: (660) 265-4212 | Sullivan County Memorial Hospital Milan Family Practice 210 N Market St Milan MO 63556-1316 Ph: (660) 265-4456 |
| NPI Number | 1619065828 |
|---|---|
| Provider Enumeration Date | 10/11/2006 |
| Last Update Date | 11/30/2015 |
| Medicare PECOS PAC ID | 7810973252 |
|---|---|
| Medicare Enrollment ID | O20151019000623 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619065828 | NPI | - | NPPES |
| 591720800 | Medicaid | MO | |
| 501720809 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (Missouri) | Primary |
Northeast Missouri Family Health Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 52334 Business Highway 5, Milan, MO 63556 Phone: 660-265-1042 Fax: 660-265-1043 | |
Sullivan County Memorial Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 630 W 3rd St, Milan, MO 63556 Phone: 660-265-4212 Fax: 660-265-4898 |