| Jefferson Medical Group Hale Clinic | |
|
221 Elm St Hale MO 64643-7113 | |
| (660) 565-2602 | |
| (660) 565-2604 |
| Full Name | Jefferson Medical Group Hale Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 221 Elm St, Hale, Missouri |
| Authorized Official Name and Position | Amy Danielle Ireland (CFO) |
| Authorized Official Contact | 6603296005 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jefferson Medical Group Hale Clinic 1502 N Jefferson St Carrollton MO 64633-1948 Ph: (660) 542-9998 | Jefferson Medical Group Hale Clinic 221 Elm St Hale MO 64643-7113 Ph: (660) 565-2602 |
| NPI Number | 1760772743 |
|---|---|
| Provider Enumeration Date | 04/12/2011 |
| Last Update Date | 10/29/2021 |
| Medicare PECOS PAC ID | 6800894379 |
|---|---|
| Medicare Enrollment ID | O20110512000437 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760772743 | NPI | - | NPPES |
| 596548800 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (Missouri) | Primary |
Hedrick Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 321 Elm Street, Hale, MO 64643 Phone: 660-565-2602 Fax: 660-565-2604 |