Provider Demographics
NPI:1710027982
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
251E00000X, 251F00000X
MO0055503336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
Provider Identifiers
StateIdentifier IDID TypeIssuer
2621402OtherNABP
MO1992845960Medicaid
MO005550OtherPHARMACY LICENSE
MO1558401851Medicaid