Organization
MED-TECH OF BRANSON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT DALE ROCHELL (OWNER/PRESIDENT)
(580) 252-8164
Entity
Organization
Contact information
Practice address
2001 HWY 248, SUITE 5, BRANSON, MO 65616-3407
(417) 334-4272
(417) 334-5272
Mailing address
1206 N HIGHWAY 81, SUITE 61, DUNCAN, OK 73533-1729
(580) 252-8164
(580) 255-1516
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
743126473
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
196461
BLUE CROSS BLUE SHIELD
MO
05
—
626176606
—
MO
Enumeration date
08/31/2006
Last updated
02/12/2009
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