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189 Iowa Blvd Trenton MO 64683-8343 | |
(660) 358-5750 | |
(660) 358-5740 |
Full Name | |
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Speciality | Clinic/Center |
Location | 189 Iowa Blvd, Trenton, Missouri |
Authorized Official Name and Position | Erin Parde (CFO) |
Authorized Official Contact | 8168805277 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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189 Iowa Blvd Trenton MO 64683-8343 Ph: (660) 358-5750 | 189 Iowa Blvd Trenton MO 64683-8343 Ph: (660) 358-5750 |
NPI Number | 1700895711 |
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Provider Enumeration Date | 08/07/2006 |
Last Update Date | 11/25/2024 |
Medicare PECOS PAC ID | 3971495532 |
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Medicare Enrollment ID | O20091005000662 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700895711 | NPI | - | NPPES |
508190006 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |