Great Mines Health Center

LBN: Great Mines Health Center
Great Mines Health Center is an health care organization with primary practice located at #1 Southtowne Drive , Potosi MO 63664-1455. The organization recently has only one registered license in Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), which is considered as the primary health care specialty. Great Mines Health Center can be contacted via phone (573) 438-9355, or through Johnson, Michael L via phone (573) 438-9355.

Contact Information

Primary practice address
#1 Southtowne Drive Potosi MO 63664-1455
Phone: (573) 438-9355
Fax: (573) 438-7892
Website:
Map and Directions
Authorized official contact:
Name: Johnson, Michael L
Phone: (573) 438-9355

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X

Profile Details

NPI number 1376536953
LBN Legal business name Great Mines Health Center
DBA Doing business as
Authorized official Johnson, Michael L
Entity Organization
Organization subpart 1 No
Enumeration date Aug 29th, 2005
Last updated Jun 23rd, 2009 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376536953 NPPES
Missouri Other 26-1878 UNITED GOVERNMENT SERVICE
Missouri MEDICAID 509215109 UNITED GOVERNMENT SERVICE

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