NORTHEAST MISSOURI HEALTH COUNCIL, INC.; NPI #1972649986

Contact Information

NORTHEAST MISSOURI HEALTH COUNCIL, INC.

402 W JEFFERSON ST
KIRKSVILLE, MO 63501-3407

Phone: 660-665-2741
Fax: 660-665-3109
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Federally Qualified Health Center (FQHC)	261QF0400X	B4[14]	Federally Qualified Health Center
Dental Hygienist	124Q00000X
Dental Public Health	1223D0001X

Indicates primary specialty

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NPI Profile & details for NORTHEAST MISSOURI HEALTH COUNCIL, INC.

NPI # 1972649986

LBN Legal business name NORTHEAST MISSOURI HEALTH COUNCIL, INC.

Authorized official ANDREW GRIMM - (EXECUTIVE DIRECTOR)

Entity Organization

Organization subpart ¹ Yes

Enumeration date 01/29/2007

Last updated 10/12/2012 - About 14 years ago

Identifiers

MO	License #	003847
MO	License #	2001012903
MO	License #	2006007559
MO	Medicaid	507477404

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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