Provider Demographics
NPI:1699728642
Name:MONITEAU COUNTY HEALTH CENTER
Entity type:Organization
Organization Name:MONITEAU COUNTY HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JERENE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUFF
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:573-796-3412
Mailing Address - Street 1:401 S FRANCIS ST
Mailing Address - Street 2:
Mailing Address - City:CALIFORNIA
Mailing Address - State:MO
Mailing Address - Zip Code:65018-2204
Mailing Address - Country:US
Mailing Address - Phone:573-796-3412
Mailing Address - Fax:573-796-7836
Practice Address - Street 1:401 S FRANCIS ST
Practice Address - Street 2:
Practice Address - City:CALIFORNIA
Practice Address - State:MO
Practice Address - Zip Code:65018-2204
Practice Address - Country:US
Practice Address - Phone:573-796-3412
Practice Address - Fax:573-796-7836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO45053Medicare ID - Type Unspecified