Provider Demographics
NPI:1467667980
Name:LESTER E COX MEDICAL CENTERS
Entity Type:Organization
Organization Name:LESTER E COX MEDICAL CENTERS
Other - Org Name:FAMILY MEDICAL CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR VP & CFO
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:MCWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-269-8811
Mailing Address - Street 1:PO BOX 505673
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63150-5673
Mailing Address - Country:US
Mailing Address - Phone:417-730-6430
Mailing Address - Fax:417-269-7567
Practice Address - Street 1:3800 S NATIONAL AVE STE 700
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5279
Practice Address - Country:US
Practice Address - Phone:417-269-8817
Practice Address - Fax:417-269-8744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO508421708Medicaid
933OtherANTHEM BCBS
DA0935Medicare PIN
CD8834Medicare PIN
MO508421708Medicaid
CD4435Medicare PIN
933OtherANTHEM BCBS
CN8494Medicare PIN
CN9581Medicare PIN
CU0251Medicare PIN
CC9890Medicare PIN