| Fordland Clinic, Inc. | |
|
11863 State Highway 13 Kimberling City MO 65686 | |
| (417) 739-1995 | |
| Not Available |
| Full Name | Fordland Clinic, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 11863 State Highway 13, Kimberling City, Missouri |
| Authorized Official Name and Position | Robert Marsh (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4177672273 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fordland Clinic, Inc. 1059 Barton Dr Fordland MO 65652-7350 Ph: (417) 767-2273 | Fordland Clinic, Inc. 11863 State Highway 13 Kimberling City MO 65686 Ph: (417) 739-1995 |
| NPI Number | 1639421365 |
|---|---|
| Provider Enumeration Date | 10/04/2012 |
| Last Update Date | 02/01/2016 |
| Medicare PECOS PAC ID | 5597794552 |
|---|---|
| Medicare Enrollment ID | O20151014001752 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639421365 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 26-1102 (Missouri) | Primary |
Skaggs Community Hospital Association Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2 Kimberling Blvd, Kimberling City, MO 65686 Phone: 417-739-2520 Fax: 417-335-7544 |