NPI | 1699066985 |
---|---|
Doing Business As | CHILDREN'S MEDICAL CENTER |
Entity Type | Organization |
Authorized Contact | LARRY MCCULLEY CEO 618-332-0694 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 208000000X Pediatrics |
Enumeration Date | 2011-04-21 |
Last Update Date | 2011-08-02 |