# MOSAIC MEDICAL CENTER - MARYVILLE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mosaic Specialty Care - West
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821562265
- **Authorized official:** DWIGHT R CARVELL (DIRECTOR OF REIMBURSEMENT)
- **Authorized official phone:** (816) 273-0473

## Contact information

- **Practice address:** 2016 S MAIN ST, MARYVILLE, MO 64468-2655
- **Practice address phone:** (660) 562-2525
- **Practice address fax:** (660) 526-4303
- **Mailing address:** 2016 S MAIN ST, MARYVILLE, MO 64468-2655
- **Mailing address phone:** (660) 562-2525
- **Mailing address fax:** (660) 526-4303

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/18/2019
- **Last updated:** 03/01/2019