| Madison Medical Center Stockhoff Memorial Nursing Home | |
|
611 West Main Street Fredericktown MO 63645 | |
| (573) 783-3341 | |
| (573) 783-1096 |
| Full Name | Madison Medical Center Stockhoff Memorial Nursing Home |
|---|---|
| Speciality | Clinic/Center |
| Location | 611 West Main Street, Fredericktown, Missouri |
| Authorized Official Name and Position | Lisa Marie Twidwell (CFO) |
| Authorized Official Contact | 5737833341 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Madison Medical Center Stockhoff Memorial Nursing Home 611 W Main St Fredericktown MO 63645-1111 Ph: (573) 783-3341 | Madison Medical Center Stockhoff Memorial Nursing Home 611 West Main Street Fredericktown MO 63645 Ph: (573) 783-3341 |
| NPI Number | 1467539031 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 12/05/2013 |
| Medicare PECOS PAC ID | 1355255886 |
|---|---|
| Medicare Enrollment ID | O20040805000502 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467539031 | NPI | - | NPPES |
| 590155107 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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