Organization
SOUTHEAST MISSOURI HEALTH NETWORK
Active
Other names
Benton Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
SARA DEANE (CHIEF FINANCIAL OFFICER)
(573) 313-2500
Entity
Organization
Contact information
Practice address
6724 STATE HIGHWAY 77, BENTON, MO 63736-8238
(573) 748-7712
(573) 545-4425
Mailing address
6738 STATE HIGHWAY 77, BENTON, MO 63736-8238
(573) 313-2500
(573) 313-2505
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
509509303
—
MO
Enumeration date
08/19/2011
Last updated
04/14/2020
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