Organization
OPCO FARMINGTON, MO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISAAC DOLE (MANAGER)
(736) 459-2467
Entity
Organization
Contact information
Practice address
705 GRAND CANYON DR, FARMINGTON, MO 63640-2161
(573) 756-8911
Mailing address
2045 W GRAND AVE STE B34572, CHICAGO, IL 60612-1576
(736) 459-2467
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
03/07/2018
Last updated
10/29/2024
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