# COUNTRY CARE MEDICAL CLINIC AND PHARMACY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508906165
- **Authorized official:** MR. DENNIS MURL GALLEMORE M.S. (CLINIC MANAGER)
- **Authorized official phone:** (417) 455-2883

## Contact information

- **Practice address:** 1504 N BUSINESS 71, NEOSHO, MO 64850-1975
- **Practice address phone:** (417) 455-2883
- **Practice address fax:** (417) 455-9358
- **Mailing address:** 1504 N BUSINESS 71, NEOSHO, MO 64850-1975
- **Mailing address phone:** (417) 455-2883
- **Mailing address fax:** (417) 455-9358

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 102015 | MO | Yes |

## Other

- **Enumeration date:** 02/06/2007
- **Last updated:** 08/22/2020