Organization
NORTHEAST MISSOURI HEALTH COUNCIL, INC.
Active
Parent organization
NORTHEAST MISSOURI HEALTH COUNCIL, INC.
Other names
Northeast Missouri Family Health Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHEAST MISSOURI HEALTH COUNCIL, INC.
Authorized official
ANDREW H. GRIMM (EXECUTIVE DIRECTOR)
(660) 627-5757
Entity
Organization
Contact information
Practice address
RR 1 BOX 55, SIGLER AVENUE, MEMPHIS, MO 63555-9726
(660) 465-7037
(660) 465-7350
Mailing address
314 E MCPHERSON ST, KIRKSVILLE, MO 63501-3557
(660) 627-5757
(660) 627-5802
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2001023603
MO
363L00000X
Nurse Practitioner
076376
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
503351827
—
MO
Enumeration date
01/29/2007
Last updated
04/01/2009
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