Mid-South Health Clinic Llc

LBN: Mid-South Health Clinic Llc
Mid-South Health Clinic Llc is an health care organization with primary practice located at 3100 Warrior Ln , Poplar Bluff MO 63901-8686. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rural Health, which is considered as the primary health care specialty. Mid-South Health Clinic Llc can be contacted via phone (573) 785-0851, or through Martin, Joetta via phone (573) 785-0851.

Contact Information

Primary practice address
3100 Warrior Ln Poplar Bluff MO 63901-8686
Phone: (573) 785-0851
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Martin, Joetta
Phone: (573) 785-0851

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rural Health 261QR1300X 031640 Missouri

Profile Details

NPI number 1073595096
LBN Legal business name Mid-South Health Clinic Llc
DBA Doing business as
Authorized official Martin, Joetta
Entity Organization
Organization subpart 1 No
Enumeration date Nov 16th, 2005
Last updated Jul 10th, 2008 - about 18 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 1073595096 NPPES
Missouri MEDICAID 598977007

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