Organization
MEDICAL MANAGEMENT OF OSAGE BEACH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STUART YACHNOWITZ (PRESIDENT)
(516) 371-4000
Entity
Organization
Contact information
Practice address
844 PASSOVER RD, OSAGE BEACH, MO 65065-2834
(573) 348-2225
Mailing address
844 PASSOVER RD, OSAGE BEACH, MO 65065-2834
(573) 348-2225
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
032117
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30162
BC BS
MO
01
—
7100077
UNITED HEALTH CARE
—
Enumeration date
07/12/2006
Last updated
08/22/2020
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