Organization
SGOH ACQUISITION INC
Active
Parent organization
SGOH ACQUISITION INC
Other names
OCH LAWRENCE COUNTY CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SGOH ACQUISITION INC
Authorized official
PAUL G TAYLOR (ADMINISTRATOR CEO)
(417) 837-4000
Entity
Organization
Contact information
Practice address
108 S HICKORY ST, MOUNT VERNON, MO 65712-1407
(417) 466-4110
(417) 466-4255
Mailing address
108 S HICKORY ST, MOUNT VERNON, MO 65712-1407
(417) 466-4110
(417) 466-4255
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
591234208
—
MO
Enumeration date
02/07/2007
Last updated
10/27/2014
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