Organization
MIDWEST DIVISION - LRHC LLC
Active
Parent organization
MIDWEST DIVISION - LRHC LLC
Other names
ODESSA MEDICAL GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
MIDWEST DIVISION - LRHC LLC
Authorized official
DARREL BOX (CEO LRHC)
(660) 259-6852
Entity
Organization
Contact information
Practice address
316 WEST 40 HWY, ODESSA, MO 64076-9612
(816) 633-5774
(816) 633-5936
Mailing address
316 WEST 40 HWY, ODESSA, MO 64076-9612
(816) 633-5774
(816) 633-5936
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010568509
—
MO
05
—
540568508
—
MO
05
—
595985805
—
MO
Enumeration date
04/26/2006
Last updated
01/06/2022
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