Healthcare Provider Details

I. General information

NPI: 1194277681
Provider Name (Legal Business Name): AIDS PROJECT OF THE OZARKS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2016
Last Update Date: 02/28/2024
Certification Date: 03/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1636 S GLENSTONE AVENUE, SUITE 108
SPRINGFIELD MO
65804-1527
US

IV. Provider business mailing address

320 S POLK STREET, SUITE 200
AMARILLO TX
79101-1436
US

V. Phone/Fax

Practice location:
  • Phone: 833-521-0877
  • Fax: 806-324-5495
Mailing address:
  • Phone: 806-242-7782
  • Fax: 806-324-5495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOEL WRIGHT
Title or Position: PRESIDENT PHARMACY SERVICES
Credential:
Phone: 806-242-7782