| Four Rivers Community Health Center | |
|
1081 E 18th St Rolla MO 65401-2448 | |
| (573) 426-2407 | |
| Not Available |
| Full Name | Four Rivers Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1081 E 18th St, Rolla, Missouri |
| Authorized Official Name and Position | Elizabeth Sparks (HR MANAGER) |
| Authorized Official Contact | 5734262407 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Four Rivers Community Health Center 1081 E 18th St Rolla MO 65401-2448 Ph: (573) 426-2407 | Four Rivers Community Health Center 1081 E 18th St Rolla MO 65401-2448 Ph: (573) 426-2407 |
| NPI Number | 1164669172 |
|---|---|
| Provider Enumeration Date | 01/13/2009 |
| Last Update Date | 02/06/2023 |
| Medicare PECOS PAC ID | 1355513581 |
|---|---|
| Medicare Enrollment ID | O20140505001869 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164669172 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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Your Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 N Main St, Suite 51g, Rolla, MO 65401 Phone: 573-426-6712 Fax: 573-426-6735 |