Healthcare Provider Details

I. General information

NPI: 1184794018
Provider Name (Legal Business Name): OZARK COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 05/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 W 3RD STREET
GAINESVILLE MO
65655-0180
US

IV. Provider business mailing address

PO BOX 180
GAINESVILLE MO
65655-0180
US

V. Phone/Fax

Practice location:
  • Phone: 417-679-3334
  • Fax: 417-679-3828
Mailing address:
  • Phone: 417-679-3334
  • Fax: 417-679-3828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number2003002302
License Number StateMO

VIII. Authorized Official

Name: RHONDA SUTER
Title or Position: ADMINISTRATOR
Credential:
Phone: 417-679-3334