Organization · Type 2 NPI

Northeast Missouri Health Council, Inc.

Federally Qualified Health Center (FQHC) · Edina, MO

NPI number 1881730893 Active

Practice location

104 E Jackson St
Edina, MO 63537-1335

Call (660) 397-3517 Map

Fax (660) 397-2307

Mailing address

1416 Crown Dr
Kirksville, MO 63501-2548

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician	207Q00000X	107529 (MO)
Family Medicine Physician	207Q00000X	R9D62 (MO)
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

Another provider at this address

Hannah Jo Braungardt, DOFamily Medicine Physician Edina, MO NPI 1780200113

NPI record

NPI: 1881730893
Entity type: Organization (Type 2)
Issued: Jan 29, 2007
Last updated: Nov 11, 2015
Status: Active
Subpart: Yes of Northeast Missouri Health Council, Inc.

Other names

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Northeast Missouri Family Health Clinic · doing business as

Authorized official

Andrew H. Grimm
Executive Director
(660) 627-5757

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 1881730893

Northeast Missouri Health Council, Inc.'s National Provider Identifier is 1881730893, issued on Jan 29, 2007. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Edina, MO. The record was last updated on Nov 11, 2015.