Kennett Pediatrics And Adolescents Medicine Llc

LBN: Kennett Pediatrics And Adolescents Medicine Llc
Kennett Pediatrics And Adolescents Medicine Llc is an health care organization with primary practice located at 211 Teaco Rd , Kennett MO 63857-3236. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Ambulatory Health Care Facilities / Rural Health. Ambulatory Health Care Facilities / Rural Health is the primary health care specialty. Kennett Pediatrics And Adolescents Medicine Llc can be contacted via phone (573) 888-0001, or through Beach, Andrew C via phone (573) 888-0001.

Contact Information

Primary practice address
211 Teaco Rd Kennett MO 63857-3236
Phone: (573) 888-0001
Fax: (573) 888-0006
Website:
Map and Directions
Authorized official contact:
Name: Beach, Andrew C Doctor of Medicine (MD)
Phone: (573) 888-0001

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X Missouri
Ambulatory Health Care Facilities / Rural Health 261QR1300X

Profile Details

NPI number 1063414704
LBN Legal business name Kennett Pediatrics And Adolescents Medicine Llc
DBA Doing business as
Authorized official Beach, Andrew C Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 12th, 2005
Last updated Jul 21st, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063414704 NPPES
Missouri MEDICAID 599371408

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