Southeast Missouri Health Network
Organization Active NPI Federally Qualified Health Center (FQHC) · Bernie, MO
NPI 1598069247 · NPPES record last updated Mar 22, 2021
Key facts
- NPI
- 1598069247
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- SOUTHEAST MISSOURI HEALTH NETWORK
- Practice address
- 741 S Walnut St
Bernie, MO 63822-8900 - Phone
- (573) 293-6930
- Fax
- (573) 293-6841
- NPI assigned
- Jan 10, 2011
- Organization subpart
- No
Authorized official
- Name
- Ms. Sara Deane
- Title
- Chief Financial Officer
- Phone
- (573) 313-2500
Corporate family (same tax ID) 13
National Provider Directory
- Tax ID family
- Southeast Missouri Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
741 S Walnut St
Bernie, MO 63822-8900
Mailing address
741 South Walnut
Bernie, MO 63822
Phone (573) 293-6930
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598069247 | Medicaid | MO |
Other names
- BERNIE DENTAL Clinic
Other providers in Bernie, MO
- Katrina Leanne Miller
- Daley M Powers
- Ronna Reaves
- Southeast Health Center of Stoddard County LLC
- Southeast Missouri Health Network
- Brandi Sparks
- Super D Drugs Acquisition Co.
- Walgreen Co
- Mariah Walker
- Winchester Nursing Center, Inc
All providers in Bernie, MO · Federally Qualified Health Center (FQHC) in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.