| Bonne Terre Health Clinic Llc | |
|
55 Nesbit Dr Bonne Terre MO 63628-1353 | |
| (573) 358-3343 | |
| (573) 358-5458 |
| Full Name | Bonne Terre Health Clinic Llc |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 55 Nesbit Dr, Bonne Terre, Missouri |
| Authorized Official Name and Position | Andrew John Ninichuck (MEMBER) |
| Authorized Official Contact | 5733583343 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bonne Terre Health Clinic Llc 55 Nesbit Dr Bonne Terre MO 63628-1353 Ph: (573) 358-3343 | Bonne Terre Health Clinic Llc 55 Nesbit Dr Bonne Terre MO 63628-1353 Ph: (573) 358-3343 |
| NPI Number | 1104071935 |
|---|---|
| Provider Enumeration Date | 11/20/2008 |
| Last Update Date | 09/24/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104071935 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 102387 (Missouri) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | 102387 (Missouri) | Primary |
Bonne Terre Medical Associates, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 30 N Allen St, Bonne Terre, MO 63628 Phone: 573-358-3343 | |
Bonne Terre Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 55 Nesbit Dr, Bonne Terre, MO 63628 Phone: 573-358-1480 Fax: 573-358-1489 | |
Primary Care Of Bonne Terre Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 527 Benham St, Bonne Terre, MO 63628 Phone: 573-358-9119 Fax: 573-358-9489 |