Organization
CITIZENS MEMORIAL HEALTH CARE FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY D FULBRIGHT (EXECUTIVE DIRECTOR)
(417) 328-6501
Entity
Organization
Contact information
Practice address
500 N MEDICAL DR, ASH GROVE, MO 65604-1005
(417) 751-2506
(417) 326-3591
Mailing address
1500 N OAKLAND AVE, BOLIVAR, MO 65613-3011
(417) 326-6000
(417) 326-3591
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
13241672
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
621752500
—
MO
Enumeration date
03/14/2012
Last updated
02/13/2020
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