|
| |
|
913 W Newton St Versailles MO 65084-1811 | |
| (660) 851-7770 | |
| (660) 827-8992 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 913 W Newton St, Versailles, Missouri |
| Authorized Official Name and Position | Michael Waller (CEO) |
| Authorized Official Contact | 8777335824 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
821 Westwood Dr Sedalia MO 65301-2102 Ph: (660) 826-4774 | 913 W Newton St Versailles MO 65084-1811 Ph: (660) 851-7770 |
| NPI Number | 1457605131 |
|---|---|
| Provider Enumeration Date | 11/02/2012 |
| Last Update Date | 02/21/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457605131 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Citizens For Health And Wellness Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 102 N Fisher St, Versailles, MO 65084 Phone: 573-378-2349 Fax: 573-378-2350 | |