Provider Demographics
NPI:1407942220
Name:FREEMAN-OAK HILL HEALTH SYSTEM
Entity Type:Organization
Organization Name:FREEMAN-OAK HILL HEALTH SYSTEM
Other - Org Name:FREEMAN HOME CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:W
Authorized Official - Last Name:GRADDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-347-6678
Mailing Address - Street 1:921 E 34TH ST
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-3933
Mailing Address - Country:US
Mailing Address - Phone:417-347-6000
Mailing Address - Fax:417-347-3675
Practice Address - Street 1:921 E 34TH ST
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-3933
Practice Address - Country:US
Practice Address - Phone:417-347-6000
Practice Address - Fax:417-347-3675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO165-18251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO580565208Medicaid