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Contact Information

TIM MITCHELL MEDICAL, INC
1504 N BUSINESS 49 HWY
NEOSHO, MO64850
 Phone: 417-451-9301
 Fax: 417-451-9307
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for TIM MITCHELL MEDICAL, INC

NPI # 1316041353
LBN Legal business name TIM MITCHELL MEDICAL, INC
Authorized official MICHAEL SMITH - (MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/11/2006
Last updated 12/29/2021 - About 4 years ago
Identifiers
MO License # 2004010987
MO Medicaid 606120509
MO Medicaid 626120505
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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