Provider Demographics
NPI:1407360449
Name:NORTHWEST HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:NORTHWEST HEALTH SERVICES, INC
Other - Org Name:GOWER FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-232-6818
Mailing Address - Street 1:303 SOUTH US HWY 169
Mailing Address - Street 2:
Mailing Address - City:GOWER
Mailing Address - State:MO
Mailing Address - Zip Code:64454
Mailing Address - Country:US
Mailing Address - Phone:816-424-6427
Mailing Address - Fax:816-416-3387
Practice Address - Street 1:313 S US HIGHWAY 169
Practice Address - Street 2:
Practice Address - City:GOWER
Practice Address - State:MO
Practice Address - Zip Code:64454-9116
Practice Address - Country:US
Practice Address - Phone:816-424-6427
Practice Address - Fax:816-416-3387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-29
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty