Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 500 Main Street, Cabool, Missouri |
Authorized Official Name and Position | Linda J. Pamperien (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 4179673311 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
500 Main Street Po Box 380 Cabool MO 65689 Ph: (417) 962-3015 | 500 Main Street Cabool MO 65689 Ph: (417) 962-3015 |
NPI Number | 1396785135 |
---|---|
Provider Enumeration Date | 06/08/2006 |
Last Update Date | 08/10/2010 |
Medicare PECOS PAC ID | 9436041696 |
---|---|
Medicare Enrollment ID | O20060323000624 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396785135 | NPI | - | NPPES |
26D0859759 | Other | MO | CLIA |
507943900 | Medicaid | MO | |
26-8603 | Other | MO | RH MEDICARE |
597943901 | Other | MO | RH MEDICAID |
Provider Name | Stephen L Hawkins |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1336188903 PECOS PAC ID: 3577474733 Enrollment ID: I20050929000433 |
Provider Name | Terry L Bruno |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013954049 PECOS PAC ID: 4385645357 Enrollment ID: I20070118000521 |
Provider Name | Lynsey R Sullivan |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417492539 PECOS PAC ID: 1951684851 Enrollment ID: I20170217001991 |
Provider Name | Samantha D Welch |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1932734092 PECOS PAC ID: 7517397573 Enrollment ID: I20200415002855 |
Provider Name | Stephanie A Thurman |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043966724 PECOS PAC ID: 5193193571 Enrollment ID: I20221115003060 |
Douglas County Public Health Services Group, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2001 Dys Dr, Cabool, MO 65689 Phone: 417-962-4344 | |