| Southeast Missouri Health Network | |
|
6724 State Highway 77 Benton MO 63736-8238 | |
| (573) 748-7712 | |
| (573) 545-4425 |
| Full Name | Southeast Missouri Health Network |
|---|---|
| Speciality | Clinic/Center |
| Location | 6724 State Highway 77, Benton, Missouri |
| Authorized Official Name and Position | Sara Deane (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 5733132500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Missouri Health Network 6738 State Highway 77 Benton MO 63736-8238 Ph: (573) 313-2500 | Southeast Missouri Health Network 6724 State Highway 77 Benton MO 63736-8238 Ph: (573) 748-7712 |
| NPI Number | 1497035661 |
|---|---|
| Provider Enumeration Date | 08/19/2011 |
| Last Update Date | 04/14/2020 |
| Medicare PECOS PAC ID | 6507818044 |
|---|---|
| Medicare Enrollment ID | O20111129000007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497035661 | NPI | - | NPPES |
| 509509303 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Comprehensive Family Health Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 142 S Winchester St, Benton, MO 63736 Phone: 573-335-1344 | |
Missouri Delta Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6468 State Highway 77, Benton, MO 63736 Phone: 573-545-3700 | |
Southeast Missouri Health Network Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6738 State Highway 77, Benton, MO 63736 Phone: 573-313-2500 Fax: 573-313-2505 |