| Samuel U. Rodgers Health Center, Inc. | |
|
1501 Nw Jefferson St Blue Springs MO 64015 | |
| (816) 224-1740 | |
| Not Available |
| Full Name | Samuel U. Rodgers Health Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1501 Nw Jefferson St, Blue Springs, Missouri |
| Authorized Official Name and Position | Monique Proctor (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 8168891928 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Samuel U. Rodgers Health Center, Inc. 1501 Nw Jefferson St Blue Springs MO 64015-7242 Ph: (816) 224-1740 | Samuel U. Rodgers Health Center, Inc. 1501 Nw Jefferson St Blue Springs MO 64015 Ph: (816) 224-1740 |
| NPI Number | 1174037519 |
|---|---|
| Provider Enumeration Date | 11/21/2017 |
| Last Update Date | 06/11/2019 |
| Medicare PECOS PAC ID | 9739092826 |
|---|---|
| Medicare Enrollment ID | O20180122000185 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174037519 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Missouri) | Primary |
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