South Central Missouri Community Health Center

NPI #1720789787 in Rolla, Missouri

Provider Information

NPI Number: 1720789787
Entity Type: Organization
Organization Name: South Central Missouri Community Health Center
Subpart: Yes (part of a larger organization)
Parent Organization: SOUTH CENTRAL MISSOURI COMMUNITY HEALTH CENTER
Primary Specialty: Clinic/Center - Federally Qualified Health Center (FQHC)
Enumeration Date: Mar 15, 2023
Last Updated: Mar 15, 2023

Practice Location

Address: 509 E 10TH ST
City: Rolla
State: Missouri
ZIP Code: 65401-3302
Phone: (573) 426-2407

Authorized Official

Name: ELIZABETH SPARKS
Title: CREDENTIALING SPECIALIST
Phone: (573) 426-2407

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC)	261QF0400X	Primary

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