Provider Demographics
NPI:1821087792
Name:OZARK CENTER
Entity Type:Organization
Organization Name:OZARK CENTER
Other - Org Name:OZARK CENTER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:PARRIGON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-347-7600
Mailing Address - Street 1:1105 E 32ND ST
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-2879
Mailing Address - Country:US
Mailing Address - Phone:417-347-7600
Mailing Address - Fax:
Practice Address - Street 1:3901 E 32ND ST
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-3312
Practice Address - Country:US
Practice Address - Phone:417-625-8412
Practice Address - Fax:417-625-8432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-13
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO005591333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO602665309Medicaid