Community Hospital-fairfax | |
102 S 6th St Tarkio MO 64491-1513 | |
(660) 736-4193 | |
(660) 736-4966 |
Full Name | Community Hospital-fairfax |
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Speciality | Clinic/Center |
Location | 102 S 6th St, Tarkio, Missouri |
Authorized Official Name and Position | Jon P Davis (CFO) |
Authorized Official Contact | 6606862320 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Community Hospital-fairfax 102 S 6th Street Tarkio MO 64491-1513 Ph: (660) 736-4193 | Community Hospital-fairfax 102 S 6th St Tarkio MO 64491-1513 Ph: (660) 736-4193 |
NPI Number | 1972507523 |
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Provider Enumeration Date | 06/10/2005 |
Last Update Date | 10/21/2019 |
Medicare PECOS PAC ID | 1557316783 |
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Medicare Enrollment ID | O20190506000754 |
Identifier | Type | State | Issuer |
---|---|---|---|
1972507523 | NPI | - | NPPES |
27443017 | Other | MO | BCBS KANSAS CITY MO |
505180802 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (Missouri) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |