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Contact Information

NEW MEDICO HEALTHCARE CORPORATION
3361 S SPRINGFIELD AVE
BOLIVAR, MO65613-9132
 Phone: 417-777-1182
 Fax: 417-777-1183
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Geriatric Psychiatry

2084P0805X 86 Physician/Neuropsychiatry
 

Professional

101YP2500X
Indicates primary specialty

NPI Profile & details for NEW MEDICO HEALTHCARE CORPORATION

NPI Number 1245250091
LBN Legal business name NEW MEDICO HEALTHCARE CORPORATION
Authorized official EDILBERTO LORENZO - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 07/21/2006
Last updated 09/25/2014 - About 12 years ago
Identifiers
AR License # R4566
KS License # 04-15475
MO License # 002181
MO License # 20010000520
MO License # 33294
TN License # 0000029442
AR Medicaid 127191001
AR Medicaid 128988002
MO Medicaid 208100107
MO Medicaid 493986483
MO Medicaid 498904515
MO Medicaid 505355909
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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