Chiroserv PC
Organization Active NPI Chiropractor · Cuba, MO
NPI 1669557583 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1669557583
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 006048 (MO)
- Legal business name
- CHIROSERV PC
- Practice address
- 114 S Buchanan St.
Cuba, MO 65453-1241 - Phone
- (573) 885-3353
- Fax
- (573) 885-3539
- NPI assigned
- Oct 26, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Louis Edward Hagene, D.C.
- Title
- Owner
- Phone
- (573) 885-3353
Practitioners 3
-
Louis Edward Hagene, D.C.
-
Jacob Glenn Heaberlin, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051020000438 | MO | Part B Supplier - Clinic/Group Practice | 5294751129 |
Receives reassigned benefits from 1 practitioner Practice locations: Cuba, MO |
National Provider Directory
Locations
114 S Buchanan St
Cuba, MO 65453
Phone (573) 885-3353
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 006048 | MO | Yes |
Addresses
Primary practice location
114 S Buchanan St.
Cuba, MO 65453-1241
Mailing address
114 S Buchanan St
Cuba, MO 65453-1241
Phone (573) 885-3353
Other providers in Cuba, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. 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.