| Eastern Missouri General Services Inc | |
|
322 No State Street Desloge MO 63601-3052 | |
| (573) 431-4510 | |
| (573) 431-4790 |
| Full Name | Eastern Missouri General Services Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 322 No State Street, Desloge, Missouri |
| Authorized Official Name and Position | Riohard Martin Secor (PRESIDENT PHYSICIAN) |
| Authorized Official Contact | 5734314510 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastern Missouri General Services Inc 322 No State Street Desloge MO 63601-3052 Ph: (573) 431-4510 | Eastern Missouri General Services Inc 322 No State Street Desloge MO 63601-3052 Ph: (573) 431-4510 |
| NPI Number | 1467518464 |
|---|---|
| Provider Enumeration Date | 12/28/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467518464 | NPI | - | NPPES |
| 0130013 | Other | UNITED HEALTH CARE | |
| 101430 | Other | MO | HL HEALTHLINK |
| 103 | Other | GHP GROUP HEALTH PLAN | |
| 04232001 | Other | MO | AETNA |
| 25000 | Other | MO | BCBS |
| 4384846 | Other | AETNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 10179 (Mississippi) | Secondary |
| 207Q00000X | Family Medicine | R9A44 (Missouri) | Primary |
Quality Health Care, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 330 N State St, Ste. C, Desloge, MO 63601 Phone: 573-431-5177 Fax: 573-431-7186 | |
Quality Health Care, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 330 N State St, Suite C, Desloge, MO 63601 Phone: 573-431-2829 Fax: 573-431-7186 |