NPIMap

Regional Health Care Clinic, Inc

Organization Active NPI Clinic Pharmacy · Sedalia, MO

NPI 1255051900 · NPPES record last updated Feb 21, 2024

Key facts

NPI
1255051900
Entity type
Organization (NPI type 2)
Primary specialty
Clinic Pharmacy 3336C0002X
Legal business name
REGIONAL HEALTH CARE CLINIC, INC
Practice address
305 W Main St
Sedalia, MO 65301-3821
Phone
(660) 310-0909
Fax
(888) 979-8868
NPI assigned
Sep 1, 2022
Organization subpart
No

Authorized official

Name
Michael Waller
Title
Ceo
Phone
(660) 310-0809

Corporate family (same tax ID) 17

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

National Provider Directory

Tax ID family
Community Free Clinic I (18 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X
Clinic Pharmacy 3336C0002X Yes

Addresses

Primary practice location

305 W Main St
Sedalia, MO 65301-3821

Mailing address

821 Westwood Dr
Sedalia, MO 65301-2102
Phone (660) 826-4774

Other names

  • Katy Trail Pharmacy Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 21, 2024.

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708473600000",
    "number": "1255051900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 WESTWOOD DR",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653012102",
            "telephone_number": "660-826-4774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W MAIN ST",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653013821",
            "telephone_number": "660-310-0909",
            "fax_number": "888-979-8868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGIONAL HEALTH CARE CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-01",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A",
        "authorized_official_last_name": "WALLER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "660-310-0809"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Katy Trail Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Katy Trail Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sedalia, MO

All providers in Sedalia, MO · Clinic Pharmacy in Missouri

Sources for this page

Verify at the official NPI Registry.