SOUTHEAST MISSOURI HEALTH NETWORK NPI 1619513215

NPI Information

NPI: 1619513215
Provider Name: SOUTHEAST MISSOURI HEALTH NETWORK

Other Name: SIKESTON ALTERNATIVE EDUCATION CENTER CLINIC

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

Specialization: Federally Qualified Health Center (FQHC)

Address:
835 W MURRAY LN
SIKESTON, MO
ZIP 63801
Phone: (573) 472-8808
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SOUTHEAST MISSOURI HEALTH NETWORK is a federally qualified health center (fqhc) clinic center in Sikeston, MO. SOUTHEAST MISSOURI HEALTH NETWORK NPI is 1619513215. The provider is registered as an organization entity type.
The provider Other Name Is Sikeston Alternative Education Center Clinic.

The provider's business location address is:

835 W MURRAY LN
SIKESTON, MO
ZIP 63801-056
Phone: (573) 472-8808

The provider's authorized official is Sara Deane .
The authorized official title is Chief Financial Officer and has the following contact phone number (573) 313-2500.

The enumeration date for this NPI number is 11/19/2019 and was last updated on 4/14/2020.

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	261QM1300X	Clinic/Center	Multi-Specialty			No
2	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	500077951	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: 11/14/2023

NPI Synchronization or Removal

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