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General NPI Number Information
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NPI Number | 1215388293
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Entity Type | Organization
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Legal Business Name | WESTERN MISSOURI MEDICAL CENTER
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Dates
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Enumeration Date | 06/30/2016
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Last Update Date | 11/01/2021
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Provider Practice Location Address
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Address Line | 905 S MAIN ST
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City | CONCORDIA
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State | MO
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Zip | 64020
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Country | US
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Telephone | 660-463-7966
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Fax | 660-463-7729
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Provider Business Mailing Address
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Address Line | 905 S MAIN ST
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City | CONCORDIA
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State | MO
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Zip | 64020-8335
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Country | US
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Telephone | 660-463-7966
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MICHAEL DEAN OHMART
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Credential |
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Telephone | 660-262-7307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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