Ob/Gyn Specialty Group/Northeast Pediatrics

LBN: Northeast Missouri Health Council, Inc.
Ob/Gyn Specialty Group/Northeast Pediatrics is an health care organization with primary practice located at 402 W Jefferson St , Kirksville MO 63501-3407. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC). Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) is the primary health care specialty. Northeast Missouri Health Council, Inc. can be contacted via phone (660) 665-3555, or through Grimm, Andrew H. via phone (660) 627-5757.

Contact Information

Primary practice address
402 W Jefferson St Kirksville MO 63501-3407
Phone: (660) 665-3555
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Grimm, Andrew H.
Phone: (660) 627-5757

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X R5810 Missouri
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 2004027805 Missouri
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 2009006697 Missouri
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 2006022612 Missouri
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 2005037590 Missouri
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X 2009001623 Missouri
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X Missouri

Profile Details

NPI number 1326184334
LBN Legal business name Northeast Missouri Health Council, Inc.
DBA Doing business as Ob/Gyn Specialty Group/Northeast Pediatrics
Authorized official Grimm, Andrew H.
Entity Organization
Organization subpart 1 No
Enumeration date Jan 29th, 2007
Last updated Oct 30th, 2012 - about 12 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 1326184334 NPPES
Missouri MEDICAID 503351801

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