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 | 1962529644 |
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Provider Enumeration Date | 03/26/2007 |
Last Update Date | 07/17/2009 |
Medicare PECOS PAC ID | 9436041696 |
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Medicare Enrollment ID | O20071120000588 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962529644 | NPI | - | NPPES |
597943901 | Medicaid | MO | |
26D0859759 | Other | MO | CLIA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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 | |