Provider Demographics
NPI:1932545977
Name:OZARK TRI-COUNTY HEALTH CARE CONSORTIUM
Entity Type:Organization
Organization Name:OZARK TRI-COUNTY HEALTH CARE CONSORTIUM
Other - Org Name:ACCESS FAMILY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DON
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCBRIDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-451-9450
Mailing Address - Street 1:PO BOX 758
Mailing Address - Street 2:475 NELSON AVE.
Mailing Address - City:NEOSHO
Mailing Address - State:MO
Mailing Address - Zip Code:65708
Mailing Address - Country:US
Mailing Address - Phone:417-451-9450
Mailing Address - Fax:417-451-8903
Practice Address - Street 1:1810 SOUTH CARNATION DR.
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:MO
Practice Address - Zip Code:65605
Practice Address - Country:US
Practice Address - Phone:417-678-1260
Practice Address - Fax:417-678-1261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-17
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO261064Medicare Oscar/Certification