# LAURIE A BEACH

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pilot Grove Rural Health Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669831640
- **Authorized official:** AMELIA D LEDBETTER (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (573) 335-4715

## Contact information

- **Practice address:** 212 COLLEGE ST, PILOT GROVE, MO 65276-1005
- **Practice address phone:** (660) 834-5100
- **Practice address fax:** (660) 834-5101
- **Mailing address:** 212 COLLEGE ST, PILOT GROVE, MO 65276-1005
- **Mailing address phone:** (660) 834-5100
- **Mailing address fax:** (660) 834-5101

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/18/2016
- **Last updated:** 02/18/2016