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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
1261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1790373850
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 : 3557 STARDUST DR
Second Line :
City : HANNIBAL
State : MO
Zip : 63401-6224
Country : US
Telephone Number : 573-603-1460
Fax Number :
Authorized Official
Title or Position : CHIEF REVENUE OFFICER
Name : MARK CONOVER
Credential :
Telephone Number : 573-603-1460
Provider Enumeration Date : 01/05/2021
Last Update Date : 07/29/2022

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Directions to “PREFERRED FAMILY HEALTHCARE, INC. ” Practice Location

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