# PHYSICIAN GROUPS LC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Centralia Family Health Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164615316
- **Authorized official:** KAREN CANTER-KOESTER (VICE PRESIDENT/AUTHORIZED OFFICIAL)
- **Authorized official phone:** (314) 996-7610

## Contact information

- **Practice address:** 1021 E HIGHWAY 22, CENTRALIA, MO 65240-1183
- **Practice address phone:** (573) 682-5580
- **Practice address fax:** (573) 682-1539
- **Mailing address:** 1600 E BROADWAY, COLUMBIA, MO 65201-5844
- **Mailing address phone:** (573) 815-6245

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/21/2007
- **Last updated:** 09/28/2021