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General NPI Number Information
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NPI Number | 1447381694
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Entity Type | Organization
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Legal Business Name | OVERTURF HEALTH MART
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | HWY 162
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City | GIDEON
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State | MO
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Zip | 63848
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Country | US
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Telephone | 573-448-5552
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Fax | 573-448-3764
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Provider Business Mailing Address
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Address Line | HWY 162
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City | GIDEON
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State | MO
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Zip | 63848
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Country | US
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Telephone | 573-448-5552
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Fax | 573-448-3764
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Authorized Official
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Title or Position | OWNER
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Name | RONNIE REHMS
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Credential |
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Telephone | 573-448-5552
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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