NORTHEAST MISSOURI HEALTH COUNCIL INC NPI 1144366154

NPI Information

NPI: 1144366154
Provider Name: NORTHEAST MISSOURI HEALTH COUNCIL INC

Doing Business As: NORTHEAST MISSOURI FAMILY HEALTH CLINIC

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
52334 BUSINESS HIGHWAY 5
MILAN, MO
ZIP 63556
Phone: (660) 265-1042
Get Directions

NORTHEAST MISSOURI HEALTH COUNCIL INC is a federally qualified health center (fqhc) clinic center in Milan, MO. NORTHEAST MISSOURI HEALTH COUNCIL INC NPI is 1144366154. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Northeast Missouri Family Health Clinic.

The provider's business location address is:

52334 BUSINESS HIGHWAY 5
MILAN, MO
ZIP 63556-040
Phone: (660) 265-1042
Fax: (660) 265-1043

The provider's authorized official is Andrew H. Grimm .
The authorized official title is Executive Director and has the following contact phone number (660) 627-5757.

The CLIA number assigned to this NPI record is 26D0985653 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/29/2007 and was last updated on 6/24/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		109328	MISSOURI	No
2	207V00000X	Obstetrics & Gynecology		2009006697	MISSOURI	No
3	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)		MISSOURI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	000014157	MEDICARE PIN
2	503351850	MEDICAID	MISSOURI
3	261866	MEDICARE OSCAR/CERTIFICATION	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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