Clint Thebeau
In Home Supportive Care in Farmington, MO. Individual provider (NPI-1).
NPI number1861979718
StatusActive
Last updated in NPPESJul 24, 2018
Details
- NPI
- 1861979718
- Entity type
- Individual (NPI-1)
- Name
- Clint Thebeau
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 24, 2018
- Last updated
- Jul 24, 2018
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 253Z00000X | In Home Supportive Care | – | MO | Yes |
Practice location
1276 W Liberty StFarmington, MO 63640
Phone 573-664-1722
Mailing address
1276 W Liberty StFarmington, MO 63640-1990
Phone 573-664-1722
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