Organization
SAMUEL U. RODGERS HEALTH CENTER, INC.
Active
Other names
Rodgers Lafayette Dental and Health, Samuel U. Rodgers Health Center Lafayette Family Medicine, Dental & WIC Services
Organization subpart
No
Provider details
NPI number
Authorized official
HILDA FUENTES (CHIEF EXECUTIVE OFFICER)
(816) 889-4600
Entity
Organization
Contact information
Practice address
811 S BUSINESS HIGHWAY 13 STE A, LEXINGTON, MO 64067
(660) 259-3823
(660) 259-4486
Mailing address
811 S BUSINESS HIGHWAY 13 STE A, LEXINGTON, MO 64067-1572
(660) 259-3823
(660) 259-4486
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500859186
—
MO
Enumeration date
08/14/2007
Last updated
06/11/2019
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