South Central Missouri Community Health Center
Family Medicine in Newburg, MO. Organization (NPI-2).
NPI number1982130118
StatusActive
Last updated in NPPESMay 9, 2017
Details
- NPI
- 1982130118
- Entity type
- Organization (NPI-2)
- Legal business name
- South Central Missouri Community Health Center
- Organization subpart
- No
- Enumeration date
- May 9, 2017
- Last updated
- May 9, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Other names
- Your Community Health Center (Doing Business As)
Practice location
701 Wolfpride DrNewburg, MO 65550-7824
Phone 573-426-6712 · Fax 573-426-6735
Mailing address
1081 E 18th StRolla, MO 65401-2448
Phone 573-426-6712 · Fax 573-426-6735
Authorized official
Kelly Miller
Ceo
5734266712
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