| Mosaic Family Care Grant City | |
|
16 W. 4th St. Grant City MO 64456 | |
| (660) 564-3322 | |
| (660) 564-3324 |
| Full Name | Mosaic Family Care Grant City |
|---|---|
| Speciality | Clinic/Center |
| Location | 16 W. 4th St., Grant City, Missouri |
| Authorized Official Name and Position | Dwight Carvell (DIRECTOR OF REIMBURSEMENT) |
| Authorized Official Contact | 8162730437 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mosaic Family Care Grant City 16 W. 4th St. Po Box 187 Grant City MO 64456 Ph: (660) 564-3322 | Mosaic Family Care Grant City 16 W. 4th St. Grant City MO 64456 Ph: (660) 564-3322 |
| NPI Number | 1053452623 |
|---|---|
| Provider Enumeration Date | 02/08/2007 |
| Last Update Date | 09/12/2024 |
| Certification Date | 09/12/2024 |
| Medicare PECOS PAC ID | 5496641896 |
|---|---|
| Medicare Enrollment ID | O20150713000474 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053452623 | NPI | - | NPPES |
| 505708305 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Secondary |
| 261QR1300X | Clinic/center - Rural Health | () | Primary |
Worth County R-iii Sbhc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 510 East Ave, Grant City, MO 64456 Phone: 816-271-8262 |