Organization
GREAT MINES HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY A ROEBACK (CEO)
(573) 438-8380
Entity
Organization
Contact information
Practice address
10047 DIAMOND RD RM 2, CADET, MO 63630-9581
(573) 438-9355
Mailing address
1 SOUTHTOWNE DR, POTOSI, MO 63664-5729
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
09/26/2022
Last updated
09/26/2022
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