NORTHEAST MISSOURI HEALTH COUNCIL INC NPI 1487038881

NPI Information

NPI: 1487038881
Provider Name: NORTHEAST MISSOURI HEALTH COUNCIL, INC

Doing Business As: MACON FAMILY HEALTH

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

Specialization: Federally Qualified Health Center (FQHC)

Address:
209 N MISSOURI ST
MACON, MO
ZIP 63552
Phone: (660) 395-5045
Get Directions

NORTHEAST MISSOURI HEALTH COUNCIL, INC is a federally qualified health center (fqhc) clinic center in Macon, MO. NORTHEAST MISSOURI HEALTH COUNCIL, INC NPI is 1487038881. The provider is registered as an organization entity type.
The provider Is Doing Business As Macon Family Health.

The provider's business location address is:

209 N MISSOURI ST
MACON, MO
ZIP 63552-151
Phone: (660) 395-5045
Fax: (660) 395-5048

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

The CLIA number assigned to this NPI record is 26D2100016 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/15/2015 and was last updated on 11/11/2015.

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	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			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	Other Provider Identifier Issuer
1	000012165	MEDICARE PIN	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

NPI Synchronization or Removal

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