Provider Demographics
NPI:1558401851
Name:COX HPS OF THE OZARKS, INC.
Entity Type:Organization
Organization Name:COX HPS OF THE OZARKS, INC.
Other - Org Name:COXHEALTH AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF HOME CARE SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:FARMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-269-4663
Mailing Address - Street 1:2240 W SUNSET ST STE 104
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-6041
Mailing Address - Country:US
Mailing Address - Phone:417-269-4663
Mailing Address - Fax:417-269-0692
Practice Address - Street 1:2240 W SUNSET ST STE 104
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-6041
Practice Address - Country:US
Practice Address - Phone:417-269-4663
Practice Address - Fax:417-269-0692
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COX HPS OF THE OZARKS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-07
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251F00000X, 251J00000X, 261Q00000X, 261QI0500X, 332B00000X, 332BD1200X, 332BN1400X, 332BP3500X, 333600000X, 3336S0011X, 3336S0011X
MO0055503336C0004X, 3336H0001X, 3336L0003X, 3336M0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO005550OtherPHARMACY LICENSE
MO1558401851Medicaid
MO1992845960Medicaid
2621402OtherNABP