| Katy Trail Community Health Cole Camp R-1 | |
|
500 S Keeney St Cole Camp MO 65325-1059 | |
| (660) 668-4427 | |
| (660) 827-8992 |
| Full Name | Katy Trail Community Health Cole Camp R-1 |
|---|---|
| Speciality | Clinic/Center |
| Location | 500 S Keeney St, Cole Camp, Missouri |
| Authorized Official Name and Position | Michael Waller (CEO) |
| Authorized Official Contact | 6606684427 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Katy Trail Community Health Cole Camp R-1 821 Westwood Dr Sedalia MO 65301-2102 Ph: (660) 826-4774 | Katy Trail Community Health Cole Camp R-1 500 S Keeney St Cole Camp MO 65325-1059 Ph: (660) 668-4427 |
| NPI Number | 1285288472 |
|---|---|
| Provider Enumeration Date | 07/26/2019 |
| Last Update Date | 02/21/2024 |
| Medicare PECOS PAC ID | 8224926092 |
|---|---|
| Medicare Enrollment ID | O20200612001257 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285288472 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Cole Camp Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1201 E Main Street, Cole Camp, MO 65325 Phone: 660-668-4411 Fax: 660-668-4861 |