Healthcare Provider Details

I. General information

NPI: 1033384870
Provider Name (Legal Business Name): SCHEIDLER RURAL HEALTH CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2008
Last Update Date: 03/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 SOUTH BYP
KENNETT MO
63857-3252
US

IV. Provider business mailing address

301 SOUTH BYP
KENNETT MO
63857-3252
US

V. Phone/Fax

Practice location:
  • Phone: 573-888-0900
  • Fax: 573-888-9588
Mailing address:
  • Phone: 573-888-0900
  • Fax: 573-888-9588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. JACOB KIER
Title or Position: OFFICE MANAGER
Credential:
Phone: 573-888-0900