| Organization Name: | SSM REGIONAL HEALTH SERVCIES |
| NPI Number: | 1316993256 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRENT VAN CONIA (PRESIDENT) |
| Mailing Address: | 2265 Bagnell Dam Blvd Ste 103 Lake Ozark |
| State: | MO US |
| Postal Code: | 650498603 |
| Phone Number: | 5733656800 |
| Fax Number: | 5733656011 |
| NPI Enumeration Date: | 05/25/2006 |
| NPI Last Update Date: | 10/28/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QU0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Urgent Care |
| Taxonomy Definition: | |