1205080876 NPI number — MEDICAL OUTSOURCING SERVICES, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205080876 NPI number — MEDICAL OUTSOURCING SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEDICAL OUTSOURCING SERVICES, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205080876
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/12/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 BAYVIEW CIR
Provider Second Line Business Mailing Address:
SUITE 400
Provider Business Mailing Address City Name:
NEWPORT BEACH
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92660-2983
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-242-5384
Provider Business Mailing Address Fax Number:
480-212-8589

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
105 E HOSPITAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SWEET SPRINGS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65351-2229
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
660-335-4700
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/10/2008

Additional Information

Authorized Official

Authorized Official Last Name:
AIHARA
Authorized Official First Name:
HOWARD
Authorized Official Middle Name:
Authorized Official Title or Position:
EXEC VP AND CFO
Authorized Official Telephone Number:
800-544-3215

Provider Taxonomy Codes

  • Taxonomy code: 261QR0208X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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