Organization
PCRMC MEDICAL GROUP, INC
Active
Other names
Phelps Health Medical Group Rolla
Organization subpart
No
Provider details
NPI number
Authorized official
JANA M COOK (VP, CHIEF FINANCIAL OFFICER)
(573) 458-7916
Entity
Organization
Contact information
Practice address
1050 W 10TH ST, ROLLA, MO 65401-2905
(573) 364-9000
(573) 458-3952
Mailing address
PO BOX 579, ROLLA, MO 65402-0579
(573) 426-2182
(573) 426-5341
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
507013605
—
MO
05
—
591072301
—
MO
Enumeration date
05/22/2007
Last updated
03/02/2026
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