Organization
GREAT MINES HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY A ROEBACK (CEO)
(573) 438-8359
Entity
Organization
Contact information
Practice address
1124 MAIN ST RM NB103, LEADWOOD, MO 63653-1214
(573) 438-9535
Mailing address
PO BOX 761, POTOSI, MO 63664-0761
(573) 438-9355
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
05/26/2021
Last updated
05/26/2021
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