| NPI | 1801822010 |
|---|---|
| Doing Business As | KOCH HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | LARRY MCCULLEY Chief Operating Officer 618-332-0783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2008-04-20 |