Organization
LESTER E COX MEDICAL CENTERS
Active
Other names
Ozarks Dialysis Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACOB M MCWAY (SR. VICE-PRESIDENT & CFO)
(417) 269-8811
Entity
Organization
Contact information
Practice address
825 E US HIGHWAY 60, SUITE B, MONETT, MO 65708-2668
(417) 354-1111
(417) 236-2666
Mailing address
1423 N JEFFERSON AVE, SPRINGFIELD, MO 65802-1917
(417) 269-3000
(417) 269-3104
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120907
BCBS MO
—
05
—
502989353
—
MO
Enumeration date
06/21/2006
Last updated
05/05/2010
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