Organization
FARMINGTON CLINIC COMPANY LLC
Active
Parent organization
FARMINGTON CLINIC COMPANY LLC
Other names
Mineral Area Doctors
Organization subpart
Yes
Provider details
NPI number
Legal business name
FARMINGTON CLINIC COMPANY LLC
Authorized official
DANIEL S SLIPKOVICK (CEO CAPELLA HEALTHCARE)
(615) 764-3049
Entity
Organization
Contact information
Practice address
1103 WEBER RD STE 202, FARMINGTON, MO 63640-3302
(573) 756-3662
(573) 756-3640
Mailing address
PO BOX 9489, BELFAST, ME 04915-9489
(573) 756-3662
(573) 756-3640
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
268974
MEDICARE GROUP NUMBER
MO
Enumeration date
09/14/2006
Last updated
12/19/2011
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