Bollinger County Health Center
Organization Active NPI Clinic/Center · Marble Hill, MO
NPI 1003881384 · NPPES record last updated Nov 19, 2012
Key facts
- NPI
- 1003881384
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- BOLLINGER COUNTY HEALTH CENTER
- Practice address
- 107 Hwy 51 N
Marble Hill, MO 63764-0409 - Phone
- (573) 238-2817
- Fax
- (573) 238-3085
- NPI assigned
- Feb 21, 2006
- Organization subpart
- No
Authorized official
- Name
- Juanita Welker
- Title
- Administrator
- Phone
- (573) 238-2817
Practitioners 1
-
Julie Elfrink, RN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140312001473 | MO | Part B Supplier - Mass Immunization (Roster Biller Only) | 9335228733 | Practice locations: Marble Hill, MO |
National Provider Directory
Locations
107 State Highway 51 N
Marble Hill, MO 63764
Phone (573) 238-2817
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
107 Hwy 51 N
Marble Hill, MO 63764-0409
Mailing address
PO Box 409
107 Hwy 51N
Marble Hill, MO 63764-0409
Phone (573) 238-2817
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 510903701 | Medicaid | MO |
Other providers in Marble Hill, MO
- Jodina Aurand
- Chelsea R Baker
- Behavior Analysis & Support, LLC
- Courtney Leigh Beussink
- Abby Rose Bohnsack
- Ronald R Brand
- Lauren Elise Buchtmann
- Andrea Danielle Cook
- Courtney L Beussink DDS LLC
- Joesph D Cravens
All providers in Marble Hill, MO · Clinic/Center in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 19, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.