Provider Demographics
NPI:1558391912
Name:LESTER E. COX MEDICAL CENTERS
Entity Type:Organization
Organization Name:LESTER E. COX MEDICAL CENTERS
Other - Org Name:COXHEALTH CENTER SEYMOUR
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 1:202 N. COMMERCIAL
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:MO
Practice Address - Zip Code:65746-8858
Practice Address - Country:US
Practice Address - Phone:417-269-2100
Practice Address - Fax:417-269-2103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO592581409Medicaid
154269OtherBLUE CROSS
MO592581409Medicaid
DA0689Medicare PIN