| Och Lawrence County Clinic | |
|
108 S Hickory St Mount Vernon MO 65712-1407 | |
| (417) 466-4110 | |
| (417) 466-4255 |
| Full Name | Och Lawrence County Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 108 S Hickory St, Mount Vernon, Missouri |
| Authorized Official Name and Position | Paul G Taylor (ADMINISTRATOR CEO) |
| Authorized Official Contact | 4178374000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Och Lawrence County Clinic 108 S Hickory St Mount Vernon MO 65712-1407 Ph: (417) 466-4110 | Och Lawrence County Clinic 108 S Hickory St Mount Vernon MO 65712-1407 Ph: (417) 466-4110 |
| NPI Number | 1568502631 |
|---|---|
| Provider Enumeration Date | 02/07/2007 |
| Last Update Date | 10/27/2014 |
| Medicare PECOS PAC ID | 5092616276 |
|---|---|
| Medicare Enrollment ID | O20150205000659 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568502631 | NPI | - | NPPES |
| 591234208 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | () | Primary |
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