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General NPI Number Information
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NPI Number | 1558497917
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Entity Type | Organization
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Legal Business Name | OZARKS MEDICAL CENTER
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 11/13/2020
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Provider Practice Location Address
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Address Line | 9104 STATE HIGHWAY 19
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City | WINONA
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State | MO
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Zip | 65588-8389
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Country | US
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Telephone | 573-325-4237
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Fax | 573-325-4996
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Provider Business Mailing Address
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Address Line | PO BOX 28
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City | WEST PLAINS
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State | MO
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Zip | 65775-0028
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Country | US
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Telephone | 573-325-4237
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Fax | 573-325-4996
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Authorized Official
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Title or Position | PROVIDER ENROLLMENT COORDINATOR
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Name | BARRYLYN ULMANIS
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Credential |
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Telephone | 417-257-6792
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 17447
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License Number State | MO
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