Provider Demographics
NPI:1093198111
Name:COWART ENTERPRISES
Entity Type:Organization
Organization Name:COWART ENTERPRISES
Other - Org Name:SENIOR AND DISABLED SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER-OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:VINCE
Authorized Official - Middle Name:RENO
Authorized Official - Last Name:COWART
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:660-262-2708
Mailing Address - Street 1:734 E CULTON ST APT 19
Mailing Address - Street 2:
Mailing Address - City:WARRENSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64093-2063
Mailing Address - Country:US
Mailing Address - Phone:660-262-2708
Mailing Address - Fax:
Practice Address - Street 1:734 E CULTON ST APT 19
Practice Address - Street 2:
Practice Address - City:WARRENSBURG
Practice Address - State:MO
Practice Address - Zip Code:64093-2063
Practice Address - Country:US
Practice Address - Phone:166-026-2270
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization