Provider Demographics
NPI:1104965037
Name:TRI-RIVERS PLANNED PARENTHOOD, INC.
Entity type:Organization
Organization Name:TRI-RIVERS PLANNED PARENTHOOD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:
Authorized Official - First Name:TONIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:STUBBLEFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-364-1509
Mailing Address - Street 1:2545 BAGNELL DAM BLVD STE 209
Mailing Address - Street 2:
Mailing Address - City:LAKE OZARK
Mailing Address - State:MO
Mailing Address - Zip Code:65049-9806
Mailing Address - Country:US
Mailing Address - Phone:573-365-3244
Mailing Address - Fax:573-365-3720
Practice Address - Street 1:2545 BAGNELL DAM BLVD STE 209
Practice Address - Street 2:
Practice Address - City:LAKE OZARK
Practice Address - State:MO
Practice Address - Zip Code:65049-9806
Practice Address - Country:US
Practice Address - Phone:573-365-3244
Practice Address - Fax:573-365-3720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical