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NPI Code Detail

MEDICARE: PREFERRED FAMILY HEALTHCARE INC

MEDICARE: PREFERRED FAMILY HEALTHCARE INC
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
1251S00000XCommunity/Behavioral Health Agency
2261QD0000XDental Clinic/Center
3261QP2300XPrimary Care Clinic/Center
4261QF0400XFederally Qualified Health Center (FQHC)MO

Other Identifiers

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

General Provider Information

NPI Number : 1639592256
Entity Type Code : Organization
Provider Name (Legal Business Name) : PREFERRED FAMILY HEALTHCARE INC
Provider Business Mailing Address
First Line : 1601 OLD SOUTH RIVER RD
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63303-4120
Country : US
Telephone Number : 636-224-1210
Fax Number : 636-246-1008
Provider Business Practice Location Address
First Line : 141 COMMUNICATION DR
Second Line :
City : HANNIBAL
State : MO
Zip : 63401-3670
Country : US
Telephone Number : 573-795-7342
Fax Number : 573-248-3080
Authorized Official
Title or Position : CHIEF REVENUE OFFICER
Name : MARK CONOVER
Credential :
Telephone Number : 660-665-1962
Provider Enumeration Date : 02/03/2014
Last Update Date : 07/29/2022

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Practice Location Address:
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1508885187 — MRS. CAROLYN KAY GREENING CNS
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1891003992 — MRS. KRISTINE MARIE WHITEHEAD MSW, LCSW
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Directions to “PREFERRED FAMILY HEALTHCARE INC ” Practice Location

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