Organization
MEDICALODGES, INC.
Active
Other names
Medicalodges Neosho
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT L HINES (CHIEF FINANCIAL OFFICER)
(620) 709-0305
Entity
Organization
Contact information
Practice address
400 W LYON DR, NEOSHO, MO 64850-9194
(417) 451-2544
(417) 451-3221
Mailing address
400 W LYON DR, NEOSHO, MO 64850-9194
(417) 451-2544
(417) 451-3221
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
026690
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101451805
—
MO
Enumeration date
10/10/2006
Last updated
02/20/2014
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