Organization · NPI-2

Complex Healthcare Of Farmington LLC

Emergency Medicine, Undersea and Hyperbaric Medicine · Farmington, MO

NPI number1104476928
StatusActive
Last updated in NPPESAug 23, 2022

Details

NPI
1104476928
Entity type
Organization (NPI-2)
Legal business name
Complex Healthcare Of Farmington LLC
Organization subpart
No
Enumeration date
Sep 13, 2019
Certification date
Aug 23, 2022
Last updated
Aug 23, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine––Yes

Practice location

555 W Pine St
Farmington, MO 63640-1439

Phone 573-223-8600

Mailing address

4201 Interway Pl
Arlington, TX 76018-5668

Phone 817-687-8014

Authorized official

Glenn Hermes
Ceo
8176926313

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