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General NPI Number Information
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NPI Number | 1740286004
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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 | 06/22/2005
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Last Update Date | 02/22/2021
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Provider Practice Location Address
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Address Line | 812 N KENTUCKY AVE
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City | WEST PLAINS
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State | MO
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Zip | 65775-2023
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Country | US
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Telephone | 417-256-3133
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Fax | 417-256-5961
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Provider Business Mailing Address
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Address Line | 812 N KENTUCKY AVE
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City | WEST PLAINS
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State | MO
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Zip | 65775-2023
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Country | US
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Telephone | 417-256-3133
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Fax | 417-256-5961
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | THOMAS KELLER
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Credential |
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Telephone | 417-257-6700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 00010613
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License Number State | MO
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