| Sgoh Acquisition Inc | |
|
101 South Main Rogersville MO 65742 | |
| (417) 753-9404 | |
| (417) 753-9137 |
| Full Name | Sgoh Acquisition Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 101 South Main, Rogersville, Missouri |
| Authorized Official Name and Position | Paul G Taylor (CEO ADMINISTRATOR) |
| Authorized Official Contact | 4178374000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sgoh Acquisition Inc 101 South Main Rogersville MO 65742 Ph: (417) 753-9404 | Sgoh Acquisition Inc 101 South Main Rogersville MO 65742 Ph: (417) 753-9404 |
| NPI Number | 1942335203 |
|---|---|
| Provider Enumeration Date | 02/23/2007 |
| Last Update Date | 08/03/2012 |
| Medicare PECOS PAC ID | 5092616276 |
|---|---|
| Medicare Enrollment ID | O20230627003164 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942335203 | NPI | - | NPPES |
| 598387306 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Lester E. Cox Medical Centers Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 151 Johnstown Drive, Rogersville, MO 65742 Phone: 417-269-2252 Fax: 417-269-2259 | |
Lester E Cox Medical Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 151 Johnstown Dr, Rogersville, MO 65742 Phone: 417-269-2252 Fax: 417-269-2259 |