Provider Demographics
NPI:1386879351
Name:FAMILY FIRST MEDICAL CENTER, INC
Entity type:Organization
Organization Name:FAMILY FIRST MEDICAL CENTER, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:OESTERREICHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-481-0700
Mailing Address - Street 1:1226 LINN ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:SIKESTON
Mailing Address - State:MO
Mailing Address - Zip Code:63801-5200
Mailing Address - Country:US
Mailing Address - Phone:573-481-0700
Mailing Address - Fax:573-481-0787
Practice Address - Street 1:1226 LINN ST
Practice Address - Street 2:SUITE F
Practice Address - City:SIKESTON
Practice Address - State:MO
Practice Address - Zip Code:63801-5200
Practice Address - Country:US
Practice Address - Phone:573-481-0700
Practice Address - Fax:573-481-0787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-20
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO268993Medicare Oscar/Certification
MO268993Medicare PIN