Organization
LESTER E. COX MEDICAL CENTERS
Active
Other names
CoxHealth Specialty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB MCWAY (EXECUTIVE VP & CFO)
(417) 269-8811
Entity
Organization
Contact information
Practice address
2240 W SUNSET ST, SUITE 106, SPRINGFIELD, MO 65807-6041
(417) 269-0650
(417) 269-0692
Mailing address
2240 W SUNSET ST, SUITE 106, SPRINGFIELD, MO 65807-6041
(417) 269-0650
(417) 269-0692
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
—
—
251J00000X
Nursing Care Agency
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
3336S0011X
Specialty Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0234260017
MEDICARE PTAN
MO
01
—
2023042801
MO BOARD OF PHARMACY
MO
Enumeration date
09/05/2023
Last updated
01/05/2024
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