Provider Demographics
NPI:1710231931
Name:VETERANS HEALTH CARE SYSTEM OF THE OZARKS
Entity Type:Organization
Organization Name:VETERANS HEALTH CARE SYSTEM OF THE OZARKS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL STAFF COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAHLGREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-587-5901
Mailing Address - Street 1:6308 S HUNTERS TRL
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65810-1968
Mailing Address - Country:US
Mailing Address - Phone:417-877-1606
Mailing Address - Fax:417-877-1606
Practice Address - Street 1:6308 S HUNTERS TRL
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65810-1968
Practice Address - Country:US
Practice Address - Phone:417-877-1606
Practice Address - Fax:417-877-1606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-09
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03017284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital