Healthcare Provider Details

I. General information

NPI: 1639384399
Provider Name (Legal Business Name): COX REHAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 08/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 E CLEVELAND AVE
MONETT MO
65708-1436
US

IV. Provider business mailing address

700 E CLEVELAND AVE
MONETT MO
65708-1436
US

V. Phone/Fax

Practice location:
  • Phone: 417-236-2480
  • Fax:
Mailing address:
  • Phone: 417-236-2480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number2006029135
License Number StateMO

VIII. Authorized Official

Name: JOLENE PALMQUIST
Title or Position: DIRECTOR OF REHAB
Credential: OTR L
Phone: 4172362480431