MEDICARE: MINERAL AREA OSTEOPATHIC HOSPITAL INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	207Q00000X	Family Medicine Physician	MO
2	207R00000X	Internal Medicine Physician	MO
3	363L00000X	Nurse Practitioner	MO

General Provider Information

NPI Number	:	1124220637
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINERAL AREA OSTEOPATHIC HOSPITAL INC

Provider Business Mailing Address
First Line	:	603 WALLACE ROAD
Second Line	:
City	:	FARMINGTON
State	:	MO
Zip	:	63640
Country	:	US
Telephone Number	:	573-756-3662
Fax Number	:	573-756-3640

Provider Business Practice Location Address
First Line	:	1103 WEBER RD
Second Line	:	SUITE 102
City	:	FARMINGTON
State	:	MO
Zip	:	63640-3326
Country	:	US
Telephone Number	:	573-756-3662
Fax Number	:	573-756-3640

Authorized Official
Title or Position	:	ACFO
Name	:	RICK JENKINS
Credential	:
Telephone Number	:	573-701-7293

Provider Enumeration Date	:	06/05/2007
Last Update Date	:	09/11/2025

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