Full Name | |
---|---|
Speciality | Clinic/center - Student Health |
Location | 200 W Main, Tamaroa, Illinois |
Authorized Official Name and Position | Rhonda C Fleming (SECRETARY) |
Authorized Official Contact | 6184965513 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 175 Tamaroa IL 62888-0175 Ph: (618) 496-5513 | 200 W Main Tamaroa IL 62888-0175 Ph: (618) 496-5513 |
NPI Number | 1669597084 |
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Provider Enumeration Date | 03/21/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1669597084 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QS1000X | Clinic/center - Student Health | (Illinois) | Primary |