Organization
FARMINGTON CLINIC COMPANY LLC
Active
Parent organization
FARMINGTON CLINIC COMPANY LLC
Other names
Bonne Terre Primary Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
FARMINGTON CLINIC COMPANY LLC
Authorized official
DANIEL S. SLIPKOVICH (CEO)
(615) 764-3000
Entity
Organization
Contact information
Practice address
55 NESBIT DR, BONNE TERRE, MO 63628-1353
(573) 358-1480
(573) 358-1489
Mailing address
TWO CORPORATE CENTRE, SUITE 200, FRANKLIN, TN 37067-2662
(615) 764-3000
(615) 764-3030
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
MO
261QR1300X
Rural Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15054
MEDICARE GROUP NUMBER
MO
05
—
504907908
—
MO
Enumeration date
09/21/2006
Last updated
07/21/2022
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