South Central Missouri Community Health Center

Organization Active NPI Federally Qualified Health Center (FQHC) · Saint Robert, MO

NPI 1083298640 · NPPES record last updated Nov 19, 2021

Key facts

NPI
1083298640
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
SOUTH CENTRAL MISSOURI COMMUNITY HEALTH CENTER
Practice address
155 Park Dr
Saint Robert, MO 65584-7860
Phone
(573) 426-2407
NPI assigned
May 10, 2021
Organization subpart
Yes
Parent organization (as reported)
SOUTH CENTRAL MISSOURI COMMUNITY HEALTH CENTER

Authorized official

Name
Elizabeth Sparks
Title
HR/Credentialing Specialist
Phone
(573) 426-2407

Corporate family (same tax ID) 12

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
South Central Missouri Community Health Center (13 organizations share this tax ID)
Part of
South Central Missouri Community Health Center

Locations

155 Park Dr
Saint Robert, MO 65584
Phone (573) 426-2407

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

155 Park Dr
Saint Robert, MO 65584-7860

Mailing address

1081 E 18TH St
Rolla, MO 65401-2448
Phone (573) 426-2407

Other providers in Saint Robert, MO

All providers in Saint Robert, MO · Federally Qualified Health Center (FQHC) in Missouri

Sources for this page

Verify at the official NPI Registry.