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Organization
PCRMC MEDICAL GROUP, INC
Active
Organization
PCRMC MEDICAL GROUP, INC
Active
Parent organization
PCRMC MEDICAL GROUP, INC
Other names
Phelps Health Medical Group Vienna
Organization subpart
Yes
Provider details
NPI number
Legal business name
PCRMC MEDICAL GROUP, INC
Authorized official
JANA M COOK (VP, CHIEF FINANCIAL OFFICER)
(573) 458-7916
Entity
Organization
Contact information
Practice address
606 HIGHWAY 63 S, VIENNA, MO 65582-8101
(573) 422-3636
(573) 422-3434
Mailing address
PO BOX 579, ROLLA, MO 65402
(573) 426-2182
(573) 426-5341
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
2007024375
MO
Other
Enumeration date
09/14/2010
Last updated
01/17/2019
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