| Southeast Health Center Of Stoddard County Llc | |
|
1003 State Hwy 25 North Bloomfield MO 63825 | |
| (573) 568-3686 | |
| Not Available |
| Full Name | Southeast Health Center Of Stoddard County Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1003 State Hwy 25 North, Bloomfield, Missouri |
| Authorized Official Name and Position | Krista Berry (CFO) |
| Authorized Official Contact | 5733316028 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Health Center Of Stoddard County Llc Po Box 368 Dexter MO 63841-0368 Ph: (573) 624-3165 | Southeast Health Center Of Stoddard County Llc 1003 State Hwy 25 North Bloomfield MO 63825 Ph: (573) 568-3686 |
| NPI Number | 1265575385 |
|---|---|
| Provider Enumeration Date | 02/15/2007 |
| Last Update Date | 09/16/2025 |
| Medicare PECOS PAC ID | 7315192515 |
|---|---|
| Medicare Enrollment ID | O20130219000420 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265575385 | NPI | - | NPPES |
| 599176906 | Medicaid | MO | |
| DC5318 | Other | MO | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (Missouri) | Primary |
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