Southeasthealth Internal Medicine Of Dexter

LBN: Southeast Health Center Of Stoddard County Llc
Southeasthealth Internal Medicine Of Dexter is an health care organization with primary practice located at 1300 N One Mile Rd , Dexter MO 63841-1042. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rural Health, which is considered as the primary health care specialty. Southeast Health Center Of Stoddard County Llc can be contacted via phone (573) 614-1951, or through Vickery, Kathy via phone (573) 614-1901.

Contact Information

Primary practice address
1300 N One Mile Rd Dexter MO 63841-1042
Phone: (573) 614-1951
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Vickery, Kathy
Phone: (573) 614-1901

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rural Health 261QR1300X Missouri

Profile Details

NPI number 1629111729
LBN Legal business name Southeast Health Center Of Stoddard County Llc
DBA Doing business as Southeasthealth Internal Medicine Of Dexter
Authorized official Vickery, Kathy
Entity Organization
Organization subpart 1 No
Enumeration date Feb 15th, 2007
Last updated Dec 1st, 2015 - about 10 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 1629111729 NPPES
Missouri MEDICAID 595968900
Missouri Other DC5219

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