| Great Mines Health Center | |
|
1124 Main St Rm Nb103 Leadwood MO 63653-1214 | |
| (573) 438-9535 | |
| Not Available |
| Full Name | Great Mines Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1124 Main St Rm Nb103, Leadwood, Missouri |
| Authorized Official Name and Position | Gregory A Roeback (CEO) |
| Authorized Official Contact | 5734388359 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Mines Health Center Po Box 761 Potosi MO 63664-0761 Ph: (573) 438-9355 | Great Mines Health Center 1124 Main St Rm Nb103 Leadwood MO 63653-1214 Ph: (573) 438-9535 |
| NPI Number | 1124693510 |
|---|---|
| Provider Enumeration Date | 05/26/2021 |
| Last Update Date | 05/26/2021 |
| Medicare PECOS PAC ID | 3072598143 |
|---|---|
| Medicare Enrollment ID | O20220705000104 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124693510 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Great Mines Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 206 Church Street, Room4, Leadwood, MO 63653 Phone: 573-438-9355 Fax: 573-438-7892 |