Organization
NORTHEAST MISSOURI HEALTH COUNCIL INC
Active
Other names
Northeast Missouri Family Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW H. GRIMM (EXECUTIVE DIRECTOR)
(660) 627-5757
Entity
Organization
Contact information
Practice address
52334 BUSINESS HIGHWAY 5, MILAN, MO 63556-3040
(660) 265-1042
(660) 265-1043
Mailing address
1416 CROWN DR, KIRKSVILLE, MO 63501-2548
(660) 627-5757
(660) 627-5802
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
109328
MO
207V00000X
Obstetrics & Gynecology Physician
2009006697
MO
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
503351850
—
MO
Enumeration date
01/29/2007
Last updated
06/24/2011
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