Organization
COMMUNITY HEALTH CTR OF CENTRAL MISSOURI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TOBY BARNETT (CFO)
(573) 632-2777
Entity
Organization
Contact information
Practice address
3400 W TRUMAN BLVD, JEFFERSON CITY, MO 65109-5712
(573) 632-2777
(573) 632-2769
Mailing address
PO BOX 104780, JEFFERSON CITY, MO 65110-4870
(573) 632-0243
(573) 632-6900
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
122300000X
Dentist
—
—
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26-1018
MEDICARE
—
05
—
507340123
—
MO
Enumeration date
05/12/2008
Last updated
02/15/2018
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