MEDICARE: PCRMC-HEALTH SERVICES, 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	251E00000X	Home Health Agency	644-6	MO

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	:	1952304578
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PCRMC-HEALTH SERVICES, INC.

Provider Business Mailing Address
First Line	:	1500 E STATE HWY 72
Second Line	:
City	:	ROLLA
State	:	MO
Zip	:	65401-3926
Country	:	US
Telephone Number	:	573-364-2425
Fax Number	:	573-364-3993

Provider Business Practice Location Address
First Line	:	1500 E STATE HWY 72
Second Line	:
City	:	ROLLA
State	:	MO
Zip	:	65401-3926
Country	:	US
Telephone Number	:	573-364-2425
Fax Number	:	573-364-3993

Authorized Official
Title or Position	:	VP, CHIEF FINANCIAL OFFICER
Name	:	JANA COOK
Credential	:
Telephone Number	:	573-458-7916

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	04/18/2023

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Directions to “PCRMC-HEALTH SERVICES, INC. ” Practice Location

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