Basic Information
| Provider Information | |||||||||
| NPI: | 1548384837 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DMS HEALTHCARE SERVICES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9 VICTORY DR | ||||||||
| Address2: | |||||||||
| City: | LIBERTY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 640681973 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8167921809 | ||||||||
| FaxNumber: | 8167921860 | ||||||||
| Practice Location | |||||||||
| Address1: | 9 VICTORY DR | ||||||||
| Address2: | |||||||||
| City: | LIBERTY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 640681973 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8167921809 | ||||||||
| FaxNumber: | 8167921860 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/19/2007 | ||||||||
| LastUpdateDate: | 05/16/2013 | ||||||||
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| AuthorizedOfficialLastName: | PARRY | ||||||||
| AuthorizedOfficialFirstName: | AMY | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 8167921809 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | D.O. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 2001005046 | MO | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.