Organization
COUNTY OF JASPER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONY MOEHR (ADMINISTRATOR)
(417) 358-3111
Entity
Organization
Contact information
Practice address
105 LINCOLN ST, CARTHAGE, MO 64836-1512
(417) 358-3111
Mailing address
105 LINCOLN ST, CARTHAGE, MO 64836-1512
(417) 358-3111
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202709515
—
MO
05
—
512031105
—
MO
Enumeration date
03/28/2007
Last updated
01/08/2014
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