Healthcare Provider Details

I. General information

NPI: 1902734767
Provider Name (Legal Business Name): OZARK TRI COUNTY HEALTH CARE CONSORTIUM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 LACLEDE AVE
NEOSHO MO
64850-9165
US

IV. Provider business mailing address

PO BOX 758 PO BOX 758
NEOSHO MO
64850-0758
US

V. Phone/Fax

Practice location:
  • Phone: 417-782-6200
  • Fax: 417-782-6210
Mailing address:
  • Phone: 417-451-9450
  • Fax: 417-451-8903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: DONALD MICHAEL MCBRIDE
Title or Position: CEO
Credential:
Phone: 417-451-9450