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Organization

ST. CLAIR COUNTY HOSPITAL DISTRICT #1

Active
Other names
Lake Area Primary Care Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
MARY C SMILEY (CEO)
(417) 646-8181
Entity
Organization

Contact information

Practice address
HWY 54 EAST, WHEATLAND, MO 65779
(417) 282-5882
(417) 282-5681
Mailing address
HWY 54 EAST, WHEATLAND, MO 65779-7501
(417) 282-5882
(417) 282-5681

Taxonomy

Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
505985200
MO
Enumeration date
10/24/2006
Last updated
04/09/2014
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