Organization
OZARKS MEDICAL CENTER
Active
Other names
Ozarks Healthcare at Home (Home Health)
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS KELLER (PRESIDENT & CEO)
(417) 257-6700
Entity
Organization
Contact information
Practice address
812 N KENTUCKY AVE, WEST PLAINS, MO 65775-2023
(417) 256-3133
(417) 256-5961
Mailing address
812 N KENTUCKY AVE, WEST PLAINS, MO 65775-2023
(417) 256-3133
(417) 256-5961
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
00010613
MO
251E00000X
Home Health Agency
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
108-35HH
STATE LICENSE
MO
01
—
117
BLUE CROSS BLUE SHIELD
MO
01
—
210161
ALLIANCE BLUE CROSS
MO
05
—
581492105
—
MO
01
—
90840
BLUE CROSS ARKANSAS
MO
01
—
IA000703
CAHABA SUBMITTER ID
MO
Enumeration date
06/22/2005
Last updated
02/22/2021
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