Organization · Type 2 NPI

Pcrmc Medical Group, Inc

Rural Health Clinic/Center · Vienna, MO

NPI number 1114235041 Active

Practice location

606 Highway 63 S
Vienna, MO 65582-8101

Call (573) 422-3636 Map

Fax (573) 422-3434

Mailing address

PO Box 579
Rolla, MO 65402

Specialties and licenses

Taxonomy	Code	License
Rural Health Clinic/Center Primary	261QR1300X	2007024375 (MO)

Rural Health Clinic/Center: Definition to come...

4 other providers at this address

NPI record

NPI: 1114235041
Entity type: Organization (Type 2)
Issued: Sep 14, 2010
Last updated: Jan 17, 2019
Status: Active
Subpart: Yes of Pcrmc Medical Group, Inc

Other names

<unavail>
Phelps Health Medical Group Vienna · doing business as

Authorized official

Jana M Cook
VP, Chief Financial Officer
(573) 458-7916

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1114235041

Pcrmc Medical Group, Inc's National Provider Identifier is 1114235041, issued on Sep 14, 2010. The primary taxonomy on file is Rural Health Clinic/Center (261QR1300X), and the practice location is in Vienna, MO. The record was last updated on Jan 17, 2019.