| Missouri Ozarks Community Health | |
|
1604 C. North Main Street Mountain Grove MO 65711 | |
| (417) 926-1713 | |
| (417) 926-1209 |
| Full Name | Missouri Ozarks Community Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 1604 C. North Main Street, Mountain Grove, Missouri |
| Authorized Official Name and Position | Tim Shryack (CEO) |
| Authorized Official Contact | 4176834831 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Missouri Ozarks Community Health Po Box 1359 Ava MO 65608-1359 Ph: (417) 683-4831 | Missouri Ozarks Community Health 1604 C. North Main Street Mountain Grove MO 65711 Ph: (417) 926-1713 |
| NPI Number | 1518342153 |
|---|---|
| Provider Enumeration Date | 07/24/2015 |
| Last Update Date | 09/02/2015 |
| Medicare PECOS PAC ID | 3072423052 |
|---|---|
| Medicare Enrollment ID | O20150828000981 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518342153 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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