MERCY CLINIC EAST COMMUNITIES NPI 1235493776

NPI Information

NPI: 1235493776
Provider Name: MERCY CLINIC EAST COMMUNITIES
Classification: Clinic/Center - 261QR1300X
Specialization: Rural Health
Entity Type: Organization
CLIA Number: 26D1074778
Address: 125 N OLD HIGHWAY 66
BOURBON, MO
ZIP 65441
Phone: (573) 679-2006

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NPI Details

MERCY CLINIC EAST COMMUNITIES is a rural health clinic center in Bourbon, MO. MERCY CLINIC EAST COMMUNITIES NPI is 1235493776. The provider is registered as an organization entity type.

The provider's business location address is:

125 N OLD HIGHWAY 66
BOURBON, MO
ZIP 65441-298
Phone: (573) 679-2006

The provider's authorized official is Jeffrey Peter Ciaramita .
The authorized official title is Community President - Clinic and has the following contact phone number (314) 525-1785.

The CLIA number assigned to this NPI record is 26D1074778 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/29/2012 and was last updated on 2/24/2021.

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	261QR1300X	Clinic/Center	Rural Health			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	596407106	MEDICAID	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: 3/30/2025

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