Organization
OZARKS MEDICAL CENTER
Active
Other names
Ozarks Healthcare at Home, Community Care
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY LEON PINCKNEY (PROVIDER ENROLLMENT SPECIALIST)
(904) 302-3989
Entity
Organization
Contact information
Practice address
812 N KENTUCKY AVE, WEST PLAINS, MO 65775-2023
(417) 256-0191
(417) 256-5961
Mailing address
812 N KENTUCKY AVE, WEST PLAINS, MO 65775-2023
(417) 256-3133
(417) 256-5961
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
260563200
—
MO
05
—
280563206
—
MO
05
—
294954102
—
MO
05
—
940563208
—
MO
Enumeration date
11/07/2005
Last updated
07/23/2021
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