Provider Demographics
NPI:1184978215
Name:F.C. OF MISSOURI INC
Entity type:Organization
Organization Name:F.C. OF MISSOURI INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-445-3750
Mailing Address - Street 1:679 W ELM ST STE 2
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:MO
Mailing Address - Zip Code:65536-3587
Mailing Address - Country:US
Mailing Address - Phone:417-532-0356
Mailing Address - Fax:
Practice Address - Street 1:679 W ELM ST STE 2
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:MO
Practice Address - Zip Code:65536-3587
Practice Address - Country:US
Practice Address - Phone:417-532-0356
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTREPID U.S.A., INC D/B/A INTREPID USA HOSPICE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-26
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based