Provider Demographics
NPI:1710950795
Name:MINERAL AREA HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:MINERAL AREA HEALTH SERVICES, INC
Other - Org Name:MINERAL AREA PHARMACY-DME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-756-4581
Mailing Address - Street 1:1101 WEBER RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FARMINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63640-3326
Mailing Address - Country:US
Mailing Address - Phone:573-756-7583
Mailing Address - Fax:573-701-9885
Practice Address - Street 1:1101 WEBER RD
Practice Address - Street 2:SUITE 103
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640-3326
Practice Address - Country:US
Practice Address - Phone:573-756-7583
Practice Address - Fax:573-701-9885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Not Answered333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0219290001Medicare ID - Type Unspecified