SGOH ACQUISITION INC NPI 1568502631

NPI Information

NPI: 1568502631
Provider Name: SGOH ACQUISITION INC

Doing Business As: OCH LAWRENCE COUNTY CLINIC

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
108 S HICKORY ST
MOUNT VERNON, MO
ZIP 65712
Phone: (417) 466-4110
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SGOH ACQUISITION INC is a rural health clinic center in Mount Vernon, MO. SGOH ACQUISITION INC NPI is 1568502631. The provider is registered as an organization entity type.
The provider Is Doing Business As Och Lawrence County Clinic.

The provider's business location address is:

108 S HICKORY ST
MOUNT VERNON, MO
ZIP 65712-407
Phone: (417) 466-4110
Fax: (417) 466-4255

The provider's authorized official is Paul G Taylor .
The authorized official title is Administrator Ceo and has the following contact phone number (417) 837-4000.

The CLIA number assigned to this NPI record is 26D1048926 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/7/2007 and was last updated on 10/27/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR1300X	Clinic/Center	Rural Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	268597	MEDICARE OSCAR/CERTIFICATION	MISSOURI
2	591234208	MEDICAID	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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