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Southeast Health Center of Reynolds County, LLC

Organization Active NPI Primary Care Clinic/Center · Ellington, MO

NPI 1285050948 · NPPES record last updated Mar 5, 2014

Key facts

NPI
1285050948
Entity type
Organization (NPI type 2)
Primary specialty
Primary Care Clinic/Center 261QP2300X
Legal business name
SOUTHEAST HEALTH CENTER OF REYNOLDS COUNTY, LLC
Practice address
100 Highway 21 N
Ellington, MO 63638-9409
Phone
(573) 663-2511
Fax
(573) 663-2815
NPI assigned
Mar 5, 2014
Organization subpart
No

Authorized official

Name
Paula E Harris
Title
Vice President Regional Operations
Phone
(573) 778-0020

Corporate family (same tax ID) 1

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

National Provider Directory

Tax ID family
Southeast Health Center of Reynolds County LLC (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Yes

Addresses

Primary practice location

100 Highway 21 N
Ellington, MO 63638-9409

Mailing address

100 Highway 21 N
Ellington, MO 63638-9409
Phone (573) 663-2511

Other names

  • SoutheastHEALTH Ellington Clinic Doing business as

Other providers in Ellington, MO

All providers in Ellington, MO · Primary Care Clinic/Center in Missouri

Sources for this page

Verify at the official NPI Registry.