| Ozarks Medical Center Healthcare Home Program | |
|
1211 Porter Wagoner Blvd #23 Parkway Center West Plains MO 65775-1826 | |
| (417) 257-6762 | |
| Not Available |
| Full Name | Ozarks Medical Center Healthcare Home Program |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1211 Porter Wagoner Blvd, West Plains, Missouri |
| Authorized Official Name and Position | Thomas Keller (PRESIDENT AND CEO) |
| Authorized Official Contact | 4172569111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ozarks Medical Center Healthcare Home Program Po Box 1100 West Plains MO 65775-1100 Ph: () - | Ozarks Medical Center Healthcare Home Program 1211 Porter Wagoner Blvd #23 Parkway Center West Plains MO 65775-1826 Ph: (417) 257-6762 |
| NPI Number | 1629104104 |
|---|---|
| Provider Enumeration Date | 02/26/2007 |
| Last Update Date | 10/19/2022 |
| Certification Date | 10/19/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629104104 | NPI | - | NPPES |
| 590492112 | Medicaid | MO | |
| 120302729 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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