GAMMA HEALTHCARE INC

Provider Demographics

• NPI: 1740361690
• Name: GAMMA HEALTHCARE INC
• Entity type: Organization
• Organization Name: GAMMA HEALTHCARE INC
• Authorized Official - Title/Position: CHAIRMAN & CEO
• Authorized Official - Prefix: MR
• Authorized Official - First Name: JERRY
• Authorized Official - Middle Name: W
• Authorized Official - Last Name: MURPHY
• Authorized Official - Phone: 573-727-5600
• Mailing Address - Street 1: 1717 W MAUD ST
• Mailing Address - City: POPLAR BLUFF
• Mailing Address - State: MO
• Mailing Address - Zip Code: 63901-4003
• Mailing Address - Country: US
• Mailing Address - Phone: 573-727-5600
• Mailing Address - Fax: 573-785-0753
• Practice Address - Street 1: 1717 W MAUD ST
• Practice Address - City: POPLAR BLUFF
• Practice Address - State: MO
• Practice Address - Zip Code: 63901-4003
• Practice Address - Country: US
• Practice Address - Phone: 573-727-5600
• Practice Address - Fax: 573-785-0753
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-10-18
• Last Update Date: 2011-12-06

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	291U00000X	Laboratories	Clinical Medical Laboratory

Provider Identifiers

State	Identifier ID	ID Type	Issuer
MS	01785013	Medicaid
	431247740LAB	Other	PREMIER PLUS BENEFITS
MO	690009308	Other	MEDICARE RAILROAD
MO	2458112	Other	UHC MEDICARE COMPLETE
MO	2458112	Other	UNITED HEALTHCARE
TN	406690419	Other	MEDICARE RAILROAD
MO	157554	Other	BLUE CROSS OF MISSOURI
MO	470766	Other	HEALTHLINK
MO	701734105	Medicaid
	1740361690	Other	MERCY
	000014651	Other	ARKANSAS COMMUNITY CARE
KS	200386900A	Medicaid
	1740361690	Other	GHP/ COVENTRY
	1740361690	Other	FIRST HEALTH
AL	113580	Medicaid
AR	159997709	Medicaid
AR	18127	Other	BLUE CROSS BLUE SHEILD OF ARKANSAS
AR	18127	Other	BLUE CROSS BLUE SHEILD OF ARKANSAS
	=========	Other	TRISOUTH
MO	470766	Other	HEALTHLINK
MO	690009308	Other	MEDICARE RAILROAD
	1740361690	Other	MERCY
MO	701734105	Medicaid