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General NPI Number Information
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NPI Number | 1699663476
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Entity Type | Organization
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Legal Business Name | PREFERRED FAMILY HEALTHCARE, INC.
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Dates
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Enumeration Date | 06/27/2025
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 6155 S GRAND BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63111-2319
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Country | US
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Telephone | 573-603-1460
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Fax |
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Provider Business Mailing Address
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Address Line | 900 E LAHARPE ST
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City | KIRKSVILLE
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State | MO
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Zip | 63501-4520
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Country | US
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Telephone | 660-665-1962
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT, MANAGED CARE
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Name | AMANDA R CARTER
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Credential |
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Telephone | 417-761-5214
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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