| Sgoh Acquisition, Inc. | |
|
155 Village Drive Sparta MO 65753-8104 | |
| (417) 634-4203 | |
| (417) 634-4505 |
| Full Name | Sgoh Acquisition, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 155 Village Drive, Sparta, Missouri |
| Authorized Official Name and Position | Paul G Taylor (CEO) |
| Authorized Official Contact | 4178374090 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sgoh Acquisition, Inc. 155 Village Drive Sparta MO 65753-8104 Ph: (417) 634-4203 | Sgoh Acquisition, Inc. 155 Village Drive Sparta MO 65753-8104 Ph: (417) 634-4203 |
| NPI Number | 1811391717 |
|---|---|
| Provider Enumeration Date | 10/21/2014 |
| Last Update Date | 11/17/2017 |
| Medicare PECOS PAC ID | 5092616276 |
|---|---|
| Medicare Enrollment ID | O20150112001888 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811391717 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Rural Healthcare Providers Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 515 Hugh Ave, Sparta, MO 65753 Phone: 417-634-3000 Fax: 417-634-3001 | |
Bridges Medical Services P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 155 Village Dr, Sparta, MO 65753 Phone: 417-634-4203 Fax: 417-634-4505 |