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300 Health Way Dr Potosi MO 63664-1420 | |
(573) 438-5451 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 300 Health Way Dr, Potosi, Missouri |
Authorized Official Name and Position | Debra A Pratt (CFO) |
Authorized Official Contact | 5734385451 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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300 Health Way Dr Potosi MO 63664-1420 Ph: (573) 438-5451 | 300 Health Way Dr Potosi MO 63664-1420 Ph: (573) 438-5451 |
NPI Number | 1205064532 |
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Provider Enumeration Date | 06/25/2009 |
Last Update Date | 08/27/2020 |
Medicare PECOS PAC ID | 3476456880 |
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Medicare Enrollment ID | O20091012000205 |
Identifier | Type | State | Issuer |
---|---|---|---|
1205064532 | NPI | - | NPPES |
594426207 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Dr. Gregory K. Terpstra D.o., Family Practice, L.l.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 612 E High St Ste 210, Potosi, MO 63664 Phone: 573-438-3660 Fax: 573-438-1140 | |
Great Mines Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: #1 Southtowne Drive, Potosi, MO 63664 Phone: 573-438-9355 Fax: 573-438-7892 | |