| Southwest City Community Clinic | |
|
109 N Broadway St South West City MO 64863-9417 | |
| (417) 762-3287 | |
| (417) 762-3255 |
| Full Name | Southwest City Community Clinic |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 109 N Broadway St, South West City, Missouri |
| Authorized Official Name and Position | Vicki Plumlee (DIRECTOR OF CLINICS) |
| Authorized Official Contact | 4177623287 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest City Community Clinic Po Box 160 109 N Broadway South West City MO 64863-0160 Ph: (417) 762-3287 | Southwest City Community Clinic 109 N Broadway St South West City MO 64863-9417 Ph: (417) 762-3287 |
| NPI Number | 1174522882 |
|---|---|
| Provider Enumeration Date | 07/15/2005 |
| Last Update Date | 04/15/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174522882 | NPI | - | NPPES |
| 596813808 | Medicaid | MO | |
| 506813815 | Medicaid | MO | |
| 100713200A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (Missouri) | Primary |
| 261QR1300X | Clinic/center - Rural Health | (Oklahoma) | Secondary |
Southwest City Community Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 109 N Broadway, South West City, MO 64863 Phone: 417-762-3287 Fax: 417-762-3255 | |
Access Family Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 411 Academy St, South West City, MO 64863 Phone: 417-451-9450 Fax: 417-451-8903 | |
Sgoh Acquisition, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 109 N Broadway St, South West City, MO 64863 Phone: 417-762-3287 |