Provider Demographics
NPI:1366626475
Name:VELMA DOWDY RCF II
Entity Type:Organization
Organization Name:VELMA DOWDY RCF II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:VELMA
Authorized Official - Middle Name:R
Authorized Official - Last Name:DOWDY
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:573-251-3555
Mailing Address - Street 1:PO BOX 278
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:MO
Mailing Address - Zip Code:63941-0278
Mailing Address - Country:US
Mailing Address - Phone:573-251-3555
Mailing Address - Fax:573-251-2589
Practice Address - Street 1:HIGHWAY 60
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:MO
Practice Address - Zip Code:63941-0278
Practice Address - Country:US
Practice Address - Phone:573-251-3555
Practice Address - Fax:573-251-2589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO032109261QG0250X
MO309-9694261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QG0250XAmbulatory Health Care FacilitiesClinic/CenterGenetics
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health