Organization
BIG SPRINGS MEDICAL ASSOCIATION
Active
Parent organization
BIG SPRINGS MEDIAL ASSOCIATION
Other names
Valley Springs Medical Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
BIG SPRINGS MEDIAL ASSOCIATION
Authorized official
SHERILYN CLARK (CEO)
(573) 663-2313
Entity
Organization
Contact information
Practice address
221 CO RD 816, BLACK, MO 63625
(537) 269-1035
(573) 269-1037
Mailing address
PO BOX 157, ELLINGTON, MO 63638-0157
(537) 663-2313
(573) 663-2441
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
509059002
—
MO
Enumeration date
10/04/2006
Last updated
07/22/2013
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