Provider Demographics
NPI:1396874475
Name:OZARK COUNTY HEALTH CENTER
Entity type:Organization
Organization Name:OZARK COUNTY HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:SUTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-679-3334
Mailing Address - Street 1:PO BOX 180
Mailing Address - Street 2:304 W. THIRD STREET
Mailing Address - City:GAINESVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65655-0180
Mailing Address - Country:US
Mailing Address - Phone:417-679-3334
Mailing Address - Fax:417-679-3828
Practice Address - Street 1:304 W. THIRD STREET
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:MO
Practice Address - Zip Code:65655-0180
Practice Address - Country:US
Practice Address - Phone:417-679-3334
Practice Address - Fax:417-679-3828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO163WC1500X251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO260904107Medicaid
MO280904103Medicaid