# SSM REGIONAL HEALTH SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SSM REGIONAL HEALTH SERVICES
- **Other names:** St. Marys Eldon Medical Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1528014156
- **Legal business name:** SSM REGIONAL HEALTH SERVICES
- **Authorized official:** BRENT VAN CONIA (PRESIDENT)
- **Authorized official phone:** (573) 761-7000

## Contact information

- **Practice address:** 1112 E NORTH ST, ELDON, MO 65026-2602
- **Practice address phone:** (573) 392-3767
- **Practice address fax:** (573) 392-1976
- **Mailing address:** PO BOX 1027, JEFFERSON CITY, MO 65102-1027
- **Mailing address phone:** (573) 761-7246
- **Mailing address fax:** (573) 761-6947

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/25/2006
- **Last updated:** 07/28/2007