Provider Demographics
NPI:1538373402
Name:EAST MISSOURI ACTION AGENCY
Entity type:Organization
Organization Name:EAST MISSOURI ACTION AGENCY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:W
Authorized Official - Last Name:BUNCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-431-5191
Mailing Address - Street 1:107 INDUSTRIAL DR
Mailing Address - Street 2:P.O. BOX N
Mailing Address - City:PARK HILLS
Mailing Address - State:MO
Mailing Address - Zip Code:63601-0358
Mailing Address - Country:US
Mailing Address - Phone:573-431-5191
Mailing Address - Fax:573-431-7449
Practice Address - Street 1:107 INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:PARK HILLS
Practice Address - State:MO
Practice Address - Zip Code:63601-3170
Practice Address - Country:US
Practice Address - Phone:573-431-5191
Practice Address - Fax:573-431-7449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO261QF0050X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical