Organization
GAMMA HEALTHCARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY W MURPHY (CHAIRMAN & CEO)
(573) 727-5600
Entity
Organization
Contact information
Practice address
1717 W MAUD ST, POPLAR BLUFF, MO 63901-4003
(573) 727-5600
(573) 785-0753
Mailing address
1717 W MAUD ST, POPLAR BLUFF, MO 63901-4003
(573) 727-5600
(573) 785-0753
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
223-0076
TN
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
9259424
IL
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
9822
MO
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
99-9-103
MS
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
OT00222
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135925709
—
AR
01
—
162202
BLUE CROSS BLUE SHIELD
MO
01
—
2458112
UHC MEDICARE COMPLETE
MO
01
—
470766
HEALTHLINK
MO
01
—
630001686
MEDICARE RAILROAD
MO
05
—
711734103
—
MO
05
—
7708309
—
MS
Enumeration date
10/25/2006
Last updated
08/29/2016
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