MEDICARE: COMPLETE HEALTHCARE LLC

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
1	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1003516485
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPLETE HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	509 SOUTH BYP
Second Line	:
City	:	KENNETT
State	:	MO
Zip	:	63857-3248
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	509 SOUTH BYP
Second Line	:
City	:	KENNETT
State	:	MO
Zip	:	63857-3248
Country	:	US
Telephone Number	:	870-243-4650
Fax Number	:

Authorized Official
Title or Position	:	COMPLIANCE
Name	:	CHRISTOPHER PRATHER
Credential	:
Telephone Number	:	573-559-3394

Provider Enumeration Date	:	03/06/2023
Last Update Date	:	03/14/2024

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Directions to “COMPLETE HEALTHCARE LLC ” Practice Location

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