| NPI | 1649027319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH BROOKS MILLER CEO 417-831-0150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2024-05-01 |
| Last Update Date | 2024-05-01 |