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General NPI Number Information
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NPI Number | 1841398773
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Entity Type | Organization
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Legal Business Name | FARMINGTON CLINIC COMPANY LLC
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 55 NESBIT DR
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City | BONNE TERRE
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State | MO
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Zip | 63628-1353
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Country | US
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Telephone | 573-358-1480
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Fax | 573-358-1489
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Provider Business Mailing Address
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Address Line | TWO CORPORATE CENTRE SUITE 200
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City | FRANKLIN
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State | TN
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Zip | 37067-2662
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Country | US
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Telephone | 615-764-3000
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Fax | 615-764-3030
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Authorized Official
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Title or Position | CEO
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Name | DANIEL S. SLIPKOVICH
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Credential |
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Telephone | 615-764-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health 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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | MO
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