| Southern Missouri Community Health Center | |
|
1137 Independence Dr West Plains MO 65775 | |
| (417) 255-8464 | |
| (417) 255-9741 |
| Full Name | Southern Missouri Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1137 Independence Dr, West Plains, Missouri |
| Authorized Official Name and Position | Bryan Adcock (CEO) |
| Authorized Official Contact | 4172558464 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Missouri Community Health Center 1137 Independence Drive West Plains MO 65775 Ph: (417) 255-8464 | Southern Missouri Community Health Center 1137 Independence Dr West Plains MO 65775 Ph: (417) 255-8464 |
| NPI Number | 1144280132 |
|---|---|
| Provider Enumeration Date | 03/24/2006 |
| Last Update Date | 03/16/2020 |
| Medicare PECOS PAC ID | 6103734058 |
|---|---|
| Medicare Enrollment ID | O20030110000001 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144280132 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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