THEODOSIA FAMILY MEDICAL CLINIC LLC NPI 1316205206

NPI Information

NPI: 1316205206
Provider Name: THEODOSIA FAMILY MEDICAL CLINIC LLC
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

CLIA Number: 26D2050353

Address:
4900 ST HWY. 160
SUITE 2
THEODOSIA, MO
ZIP 65761
Phone: (417) 273-2300
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THEODOSIA FAMILY MEDICAL CLINIC LLC is a rural health clinic center in Theodosia, MO. THEODOSIA FAMILY MEDICAL CLINIC LLC NPI is 1316205206. The provider is registered as an organization entity type.

The provider's business location address is:

4900 ST HWY. 160
SUITE 2
THEODOSIA, MO
ZIP 65761-539
Phone: (417) 273-2300
Fax: (417) 273-2316

The provider's authorized official is Lisa A Schofield .
The authorized official title is Owner Of Clinic and has the following contact phone number (417) 273-2300.

The CLIA number assigned to this NPI record is 26D2050353 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/27/2012 and was last updated on 9/4/2013.

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

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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