MEDICARE: BURRELL, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
3	324500000X	Substance Abuse Rehabilitation Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780393496
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BURRELL, INC.

Provider Business Mailing Address
First Line	:	2885 W BATTLEFIELD ST
Second Line	:
City	:	SPRINGFIELD
State	:	MO
Zip	:	65807-3952
Country	:	US
Telephone Number	:	417-761-5000
Fax Number	:	417-761-5065

Provider Business Practice Location Address
First Line	:	90 E LESLIE LN
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65202-1589
Country	:	US
Telephone Number	:	573-875-8880
Fax Number	:	573-442-3830

Authorized Official
Title or Position	:	VP MANAGED CARE
Name	:	AMANDA R CARTER
Credential	:
Telephone Number	:	417-761-5126

Provider Enumeration Date	:	11/21/2022
Last Update Date	:	03/13/2026

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Directions to “BURRELL, INC. ” Practice Location

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