Organization · Type 2 NPI

Northeast Missouri Health Council, Inc.

Federally Qualified Health Center (FQHC) · Kirksville, MO

NPI number 1972649986 Active

Practice location

402 W Jefferson St
Kirksville, MO 63501-3407

Call (660) 665-2741 Map

Fax (660) 665-3109

Mailing address

1416 Crown Dr, P O Box 1027
Kirksville, MO 63501-2548

Specialties and licenses

Taxonomy	Code	License
Public Health Dentistry	1223D0001X	2001012903 (MO)
Public Health Dentistry	1223D0001X	2006007559 (MO)
Dental Hygienist	124Q00000X	003847 (MO)
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

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

20 other providers at this address

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NPI record

NPI: 1972649986
Entity type: Organization (Type 2)
Issued: Jan 29, 2007
Last updated: Oct 12, 2012
Status: Active
Subpart: Yes of Northeast Missouri Health Council, Inc.

Other names

<unavail>
Northeast Missouri Dental 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 1972649986

Northeast Missouri Health Council, Inc.'s National Provider Identifier is 1972649986, issued on Jan 29, 2007. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Kirksville, MO. The record was last updated on Oct 12, 2012.