SOUTHEAST HEALTH CENTER OF STODDARD COUNTY LLC


Address: 1003 State Hwy 25 North, Bloomfield, MO 63825
Phone: 5735683686

SOUTHEAST HEALTH CENTER OF STODDARD COUNTY LLC (NPI# 1265575385) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1265575385
Entity Type Organization
Organization Name SOUTHEAST HEALTH CENTER OF STODDARD COUNTY LLC
Other Organization Name SOUTHEASTHEALTH BLOOMFIELD CLINIC
Practice Address 1003 State Hwy 25 North
Bloomfield
MO 63825
Mailing Address Po Box 368
Dexter
MO 63841-0368
Practice Telephone 5735683686
Mailing Telephone 5736243165
Mailing Fax Number 5736243157
Enumeration Date 2007-02-15
Last Update Date 2013-10-18
Authorized Official Name PAULE E HARRIS (VICE PRESIDENT REGIONAL OPERATIONS)
Authorized Official Telephone 5737780020
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QR1300X Clinic/Center
Specialization: Rural Health
MO Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
MO 599176906 05
MO RAILROAD MEDICARE DC5318 01

Other Provider/Organization Names

Other Name Type Code
SoutheastHEALTH Bloomfield Clinic Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1639736457 Southeast Health Center of Stoddard County LLC Clinic/Center 800 Us Highway 61, New Madrid, MO 63869-1106 2019-05-28
1477997567 Southeast Health Center of Stoddard County LLC Emergency Medicine 1200 N One Mile Road, Dexter, MO 63841-1000 2013-04-19
1679041040 Southeast Health Center of Stoddard County LLC Clinic/Center 522 Virginia St, Sikeston, MO 63801-5812 2018-11-05
1679820286 Southeast Health Center of Stoddard County LLC Clinic/Center 810 N Walnut St, Bernie, MO 63822-8901 2012-08-14
1629111729 Southeast Health Center of Stoddard County LLC Clinic/Center 1300 N One Mile Rd, Dexter, MO 63841-1042 2007-02-15

Office Location

Street Address 1003 STATE HWY 25 NORTH
City BLOOMFIELD
State MO
Zip Code 63825

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1073039715 Susan L Shea Counselor 402 Barbara Street, Bloomfield, MO 63825 2017-08-15
1750571931 Robin Denise Osborn Counselor 206 S Prairie Street, Bloomfield, MO 63825 2007-07-25
1588714992 Bloomfield R-14 Schools Local Education Agency (LEA) 505 Court St., Bloomfield, MO 63825 2007-01-11
1326108226 Dexter Hospital LLC Internal Medicine 1003 Highway 25 North, Bloomfield, MO 63825 2006-12-11
1245317700 Amy Holland Nurse Practitioner 1003 Hwy 25 N, Bloomfield, MO 63825 2006-11-01
1225112345 Town Pharmacy Inc. Pharmacy 700 Highway 25 South, Bloomfield, MO 63825 2006-10-25
1114015682 Cecil Ray Vincent Sr. Pharmacist 302 S Prairie, Bloomfield, MO 63825 2006-10-10
1033182092 Peter W Somers Family Medicine 101 South Prairie Street, Bloomfield, MO 63825 2006-02-09
1023424041 Poplar Bluff Regional Medical Center, LLC Family Medicine 101 South Prairie Street, Bloomfield, MO 63825 2014-07-10
1528205788 Robert Lee Joplin Driver 206 S Prairie Street, Bloomfield, MO 63825 2009-01-09
Find all providers in zip 63825

Taxonomy Information

Taxonomy Code 261QR1300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rural Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1174550115 Poplar Bluff Regional Medical Center LLC Clinic/Center 101 S. Prairie, Bloomfield, MO 63825-0200 2006-06-26
1699753285 Greene County Health Clinic, LLC Clinic/Center 12 W Main St, Bloomfield, IN 47424-1424 2006-01-04
1821413667 Davis County Hospital Clinic/Center 509 N Madison St, Ste 100, Bloomfield, IA 52537-1271 2014-03-04

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1871102137 Washington County Memorial Hospital Clinic/Center 14206 Hwy C, Belgrade, MO 63622 2020-07-23
1891325072 Scotland County Memorial Hospital Clinic/Center 55682 State Highway 6 Ste A, Edina, MO 63537-4268 2020-01-16
1639736457 Southeast Health Center of Stoddard County LLC Clinic/Center 800 Us Highway 61, New Madrid, MO 63869-1106 2019-05-28
1134633456 Pike County Memorial Hospital Clinic/Center 1420 S Business 61 Unit Fde, Bowling Green, MO 63334-5230 2017-11-22
1720505894 Perry County Health System Clinic/Center 210 Hospital Ln Ste 202, Perryville, MO 63775-4200 2017-08-29
1427572007 Missouri Delta Medical Center Clinic/Center 209 W Yoakum Ave, Chaffee, MO 63740-1138 2017-07-26
1790213676 Jackson Primary Care LLC Clinic/Center 2685 E Main St Ste A, Jackson, MO 63755-2474 2017-05-23
1972050581 Sgoh Acquisition, Inc. Clinic/Center 912b State Highway 59, Goodman, MO 64843-8252 2016-09-01
1144605312 Nevada City Hospital Clinic/Center 627 S Ash St Ste B, Nevada, MO 64772 2015-07-29
1669856829 Ssm Regional Health Services Clinic/Center 2511 W Edgewood Dr Ste F, Jefferson City, MO 65109-5869 2015-07-16
Find all providers with the same taxonomy

Competitor

Search similar providers

City BLOOMFIELD
Zip Code 63825

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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