Southeast Missouri Health Network in Malden - Federally Qualified Health Center (fqhc)
Southeast Missouri Health Network - NPI 1720209794
Southeast Missouri Health Network is a Federally Qualified Health Center (fqhc) in Malden, Missouri. Southeast Missouri Health Network practices all healthcare services and medical treatments related to Federally Qualified Health Center (fqhc). The NPI Number for Southeast Missouri Health Network is 1720209794. The last update date is 2013-05-02.
Southeast Missouri Health Network's current location address is 700 N Douglass St, Malden, Missouri. You can contact this provider via phone number 5737487701 and fax number 5737482554. The mailing address for Southeast Missouri Health Network is 700 N Douglass St, Malden, Missouri. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Southeast Missouri Health Network |
|---|---|
| Address | 700 N Douglass St, Malden, Missouri |
| Phone Number | 5737487701 |
| Fax Number | 5737482554 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CEO |
|---|---|
| Authorized Official Name | White A Cheryl |
| Telephone Number | 5737482404 |
NPI Number Detail
| NPI Number | 1720209794 |
|---|---|
| Provider Enumeration Date | 2007-05-01 |
| Last Updated Date | 2013-05-02 |
Provider Mailing Address Detail
| Address | 700 N Douglass St |
|---|---|
| City | Malden |
| State | Missouri (MO) |
| Post Code | 638631510 |
| Phone Number | 5737487701 |
| Fax Number | 5737482554 |
Provider's Primary Taxonomy Detail
| Speciality | Federally Qualified Health Center (fqhc) |
|---|---|
| Taxonomy | 261Qf0400X |
|
Definition: Provides primary and preventive care services in underserved areas, receiving certain federal funding grants. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 500704028 | MO | -- | |
| 10626 | MO | GROUP PTAN |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Southeast Missouri Health Network by the Centers for Medicare & Medicaid Services?
The Southeast Missouri Health Network has been issued the NPI (National Provider Identifier) 1720209794 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you share the physical location details of Southeast Missouri Health Network?
The Southeast Missouri Health Network is situated at 700 N Douglass St, in the city of Malden, state of MO, with the zip code 638631510.
What is the area of specialization for Southeast Missouri Health Network, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Southeast Missouri Health Network is Federally Qualified Health Center (fqhc), and the corresponding taxonomy code that categorizes this area of expertise is 261Qf0400X.
When was the Southeast Missouri Health Network's 1720209794 issued?
The Southeast Missouri Health Network's 1720209794 was issued on 2007-05-01.
As of what date were the details related to Southeast Missouri Health Network most recently updated or revised?
The information pertaining to Southeast Missouri Health Network, including its address, specialty, and other relevant details, was last updated or revised on 2013-05-02.
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