Provider Demographics
NPI:1043250905
Name:OZARK TRI-COUNTY HEALTH CARE CONSORTIUM
Entity Type:Organization
Organization Name:OZARK TRI-COUNTY HEALTH CARE CONSORTIUM
Other - Org Name:ACCESS FAMILY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MCBRIDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-451-9450
Mailing Address - Street 1:475 NELSON AVENUE
Mailing Address - Street 2:PO BOX 758
Mailing Address - City:NEOSHO
Mailing Address - State:MO
Mailing Address - Zip Code:64850-0758
Mailing Address - Country:US
Mailing Address - Phone:417-451-9450
Mailing Address - Fax:417-451-9456
Practice Address - Street 1:927 N 71 BUSINESS HWY
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:MO
Practice Address - Zip Code:64831-9753
Practice Address - Country:US
Practice Address - Phone:417-845-2273
Practice Address - Fax:417-845-0094
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OZARK TRI-COUNTY HEALTH CARE CONSORTIUM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-08
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO=========OtherEIN