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NPI Code Detail

MEDICARE: ADVANCED SENIOR CARE, INC

MEDICARE: ADVANCED SENIOR CARE, 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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1821305376
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED SENIOR CARE, INC
Provider Business Mailing Address
First Line : 910 N COLLEGE AVE
Second Line : SUITE 4
City : COLUMBIA
State : MO
Zip : 65201-4797
Country : US
Telephone Number : 636-642-1215
Fax Number : 573-234-4799
Provider Business Practice Location Address
First Line : 910 N COLLEGE AVE
Second Line : SUITE 4
City : COLUMBIA
State : MO
Zip : 65201-4797
Country : US
Telephone Number : 636-642-1215
Fax Number : 573-234-4769
Authorized Official
Title or Position : PRESIDENT
Name : BRAD BEAIRD
Credential : MD
Telephone Number : 636-642-1215
Provider Enumeration Date : 09/04/2010
Last Update Date : 11/06/2024

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Directions to “ADVANCED SENIOR CARE, INC ” Practice Location

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