| Long Term Care Of North County Llc | |
| 
					4401 Parker Rd Black Jack MO 63033-4266  | |
| (314) 312-0720 | |
| Not Available | 
| Full Name | Long Term Care Of North County Llc | 
|---|---|
| Speciality | Internal Medicine | 
| Location | 4401 Parker Rd, Black Jack, Missouri | 
| Authorized Official Name and Position | Mary Colette Schmidt (OWNER) | 
| Authorized Official Contact | 3149224048 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Long Term Care Of North County Llc Po Box 611 Florissant MO 63032-0611 Ph: (314) 312-0720  | Long Term Care Of North County Llc 4401 Parker Rd Black Jack MO 63033-4266 Ph: (314) 312-0720  | 
| NPI Number | 1962915074 | 
|---|---|
| Provider Enumeration Date | 11/10/2017 | 
| Last Update Date | 12/22/2023 | 
| Medicare PECOS PAC ID | 9032476171 | 
|---|---|
| Medicare Enrollment ID | O20171128003166 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1962915074 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary | 
| Provider Name | Mary C Schmidt | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1174504682 PECOS PAC ID: 7719069103 Enrollment ID: I20080123000918  | 
Ameriwound Physicians Mo Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13700 Old Halls Ferry Rd, Black Jack, MO 63033 Phone: 314-355-0760  | |
Chestnut Health Of Missouri Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 13700 Old Halls Ferry Rd, Black Jack, MO 63033 Phone: 314-355-0760 Fax: 703-649-6188  |