| Northwest Health Services, Inc | |
|
1303 State Street Mound City MO 64470-1717 | |
| (660) 442-5464 | |
| (660) 442-5927 |
| Full Name | Northwest Health Services, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1303 State Street, Mound City, Missouri |
| Authorized Official Name and Position | Matt Younger (CEO) |
| Authorized Official Contact | 8162326818 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Health Services, Inc 1303 State Street Mound City MO 64470-1717 Ph: (660) 442-5464 | Northwest Health Services, Inc 1303 State Street Mound City MO 64470-1717 Ph: (660) 442-5464 |
| NPI Number | 1437270915 |
|---|---|
| Provider Enumeration Date | 04/03/2007 |
| Last Update Date | 11/10/2021 |
| Medicare PECOS PAC ID | 7113835174 |
|---|---|
| Medicare Enrollment ID | O20080731000504 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437270915 | NPI | - | NPPES |
| 502111248 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Community Hospital Association Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 514 State St, Mound City, MO 64470 Phone: 660-442-3181 Fax: 660-686-2618 |