Organization
PHELPS COUNTY REGIONAL MEDICAL CENTER
Active
Parent organization
PHELPS COUNTY REGIONAL MEDICAL CENTER OUTPATIENT PHARMACY
Other names
Phelps Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHELPS COUNTY REGIONAL MEDICAL CENTER OUTPATIENT PHARMACY
Authorized official
JASON SHENEFIELD (CEO)
(573) 458-7975
Entity
Organization
Contact information
Practice address
1000 W 10TH ST, ROLLA, MO 65401-2905
(573) 458-8899
Mailing address
PO BOX 220, ROLLA, MO 65402-0220
(573) 458-8899
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
14-48
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010419109
—
MO
Enumeration date
05/31/2006
Last updated
09/24/2021
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