Provider Demographics
NPI:1346790508
Name:WESTERN MISSOURI MEDICAL CENTER
Entity Type:Organization
Organization Name:WESTERN MISSOURI MEDICAL CENTER
Other - Org Name:FAMILY PRACTICE OF CENTRAL MISSOURI - WARRENSBURG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:OHMART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-262-7307
Mailing Address - Street 1:513 BURKARTH RD
Mailing Address - Street 2:
Mailing Address - City:WARRENSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64093-3103
Mailing Address - Country:US
Mailing Address - Phone:660-747-7751
Mailing Address - Fax:
Practice Address - Street 1:513 BURKARTH RD
Practice Address - Street 2:
Practice Address - City:WARRENSBURG
Practice Address - State:MO
Practice Address - Zip Code:64093
Practice Address - Country:US
Practice Address - Phone:660-747-7751
Practice Address - Fax:660-747-8398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-11
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty