Provider Demographics
NPI:1245507326
Name:CLINICAL RESEARCH OF THE OZARKS, INC.
Entity type:Organization
Organization Name:CLINICAL RESEARCH OF THE OZARKS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:PEDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-364-7777
Mailing Address - Street 1:509 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:ROLLA
Mailing Address - State:MO
Mailing Address - Zip Code:65401-3302
Mailing Address - Country:US
Mailing Address - Phone:573-364-7777
Mailing Address - Fax:573-341-2981
Practice Address - Street 1:509 E 10TH ST
Practice Address - Street 2:
Practice Address - City:ROLLA
Practice Address - State:MO
Practice Address - Zip Code:65401-3302
Practice Address - Country:US
Practice Address - Phone:573-364-7777
Practice Address - Fax:573-341-2981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch