MEDICARE: WEST PLAINS HEALTH SERVICE, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	12029858	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	C1210	OTHER	HOMELINK
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578566295
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST PLAINS HEALTH SERVICE, INC.

Provider Business Mailing Address
First Line	:	1703 W 8TH ST
Second Line	:
City	:	WEST PLAINS
State	:	MO
Zip	:	65775-2007
Country	:	US
Telephone Number	:	417-256-0900
Fax Number	:	417-256-8199

Provider Business Practice Location Address
First Line	:	1703 W 8TH ST
Second Line	:
City	:	WEST PLAINS
State	:	MO
Zip	:	65775-2007
Country	:	US
Telephone Number	:	417-256-0900
Fax Number	:	417-256-8199

Authorized Official
Title or Position	:	FINANCIAL MANAGER
Name	:	CATHY SMITH-FRIGA
Credential	:
Telephone Number	:	417-256-0900

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	12/27/2021

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