Organization
SOUTHEAST MISSOURI HEALTH NETWORK
Active
Other names
Otto Bean Medical Clinic, otto bean 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
500 RUSSELL ST, KENNETT, MO 63857-2102
(573) 717-1332
(573) 717-1335
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
—
500704036
—
MO
Enumeration date
05/01/2007
Last updated
04/14/2020
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