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NPI Code Detail

MEDICARE: NEVADA MEDICAL CLINIC L.L.C.

MEDICARE: NEVADA MEDICAL CLINIC L.L.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMO
2261QR1300XRural Health Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104821867
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEVADA MEDICAL CLINIC L.L.C.
Provider Business Mailing Address
First Line : 900 S ADAMS ST
Second Line :
City : NEVADA
State : MO
Zip : 64772-3210
Country : US
Telephone Number : 417-667-6015
Fax Number : 417-667-4234
Provider Business Practice Location Address
First Line : 900 S ADAMS ST
Second Line :
City : NEVADA
State : MO
Zip : 64772-3210
Country : US
Telephone Number : 417-667-6015
Fax Number : 417-667-4234
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. JAMES D HARMS
Credential :
Telephone Number : 417-667-6015
Provider Enumeration Date : 06/17/2005
Last Update Date : 07/21/2022

Similar Medicare Providers

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Practice Location Address:
900 S ADAMS ST
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64772-3210
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1205831997 — FREDERICK L THOMPSON M.D.
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1356346050 — HEATHER RUSSELL M.D.
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64772-3210
Practice Phone: 417-667-6015
Practice Fax: 417-667-3007
1679554406 — COMMUNITY PHARMACY, INC.
Practice Location Address:
900 S ADAMS ST
NEVADA, MO
64772-3210
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1104854660 — DR. BYRON LEONARD PERKINSON M.D.
Practice Location Address:
900 S ADAMS ST
NEVADA, MO
64772-3210
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1013081090 — SUMMERS PHARMACY OF NEVADA LLC
Practice Location Address:
900 S ADAMS ST
NEVADA, MO
64772-3210
Practice Phone: 417-667-6044
Practice Fax: 417-667-0544

Directions to “NEVADA MEDICAL CLINIC L.L.C. ” Practice Location

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