| Pilot Grove Medical Clinic At Fitzgibbon | |
|
212 College St Pilot Grove MO 65276-1005 | |
| (660) 831-3728 | |
| Not Available |
| Full Name | Pilot Grove Medical Clinic At Fitzgibbon |
|---|---|
| Speciality | Clinic/Center |
| Location | 212 College St, Pilot Grove, Missouri |
| Authorized Official Name and Position | Nancy Harris (CFO/COO) |
| Authorized Official Contact | 6608867431 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pilot Grove Medical Clinic At Fitzgibbon Po Box 801303 Kansas City MO 64180-1303 Ph: (660) 831-3728 | Pilot Grove Medical Clinic At Fitzgibbon 212 College St Pilot Grove MO 65276-1005 Ph: (660) 831-3728 |
| NPI Number | 1073279873 |
|---|---|
| Provider Enumeration Date | 11/16/2021 |
| Last Update Date | 03/05/2024 |
| Medicare PECOS PAC ID | 2567351570 |
|---|---|
| Medicare Enrollment ID | O20220621001658 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073279873 | NPI | - | NPPES |
| 268790 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
Pilot Grove Rural Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 212 College St, Pilot Grove, MO 65276 Phone: 660-834-5100 Fax: 660-834-5101 | |
Pilot Grove Rural Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 212 College St, Pilot Grove, MO 65276 Phone: 660-834-5100 Fax: 660-834-5101 |