Provider Demographics
NPI:1790922920
Name:COMMUNITY HEALTH CTR OF CENTRAL MISSOURI
Entity Type:Organization
Organization Name:COMMUNITY HEALTH CTR OF CENTRAL MISSOURI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FIN OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TOBY
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-632-0243
Mailing Address - Street 1:PO BOX 104780
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65110-4780
Mailing Address - Country:US
Mailing Address - Phone:573-632-0243
Mailing Address - Fax:573-632-0248
Practice Address - Street 1:1905 STADIUM BLVD
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-1961
Practice Address - Country:US
Practice Address - Phone:573-632-2777
Practice Address - Fax:573-632-2769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-09
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)