Provider Demographics
NPI:1467614206
Name:SKAGGS COMMUNITY HOSPITAL ASSOCIATION
Entity Type:Organization
Organization Name:SKAGGS COMMUNITY HOSPITAL ASSOCIATION
Other - Org Name:SKAGGS MEDICAL CARE-GREENWALD CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:ERIXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-335-7350
Mailing Address - Street 1:15765 STATE HWY 13
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BRANSON WEST
Mailing Address - State:MO
Mailing Address - Zip Code:65737-8673
Mailing Address - Country:US
Mailing Address - Phone:417-272-3151
Mailing Address - Fax:
Practice Address - Street 1:15765 STATE HWY 13
Practice Address - Street 2:SUITE 3
Practice Address - City:BRANSON WEST
Practice Address - State:MO
Practice Address - Zip Code:65737-8673
Practice Address - Country:US
Practice Address - Phone:417-272-3151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty