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Organization

FC OF MISSOURI INC

Active
Other names
Intrepid USA Healthcare Services
Organization subpart
No

Provider details

NPI number
Authorized official
MR. PAUL D FOSTER (CEO)
(214) 445-3750
Entity
Organization

Contact information

Practice address
4305 S. NATIONAL AVE, SPRINGFIELD, MO 65810-2607
(417) 883-5118
(417) 883-7436
Mailing address
4055 VALLEY VIEW LN, 5TH FLOOR, DALLAS, TX 75244-5074
(214) 445-3750
(214) 445-3902

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
943539809
MO
163W00000X
Registered Nurse
HHA7502
MO
251E00000X
Home Health Agency
Primary
750-7HH
MO
251E00000X
Home Health Agency
HHA7502
MO
3747P1801X
Personal Care Attendant
263539801
MO
374U00000X
Home Health Aide
0002286
MO
376J00000X
Homemaker
283539807
MO
376J00000X
Homemaker
HHA7502
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
283539807
MO
05
581962909
MO
05
943539809
MO
Enumeration date
11/18/2005
Last updated
04/19/2016
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