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PEMISCOT COUNTY MEMORIAL HOSPITAL NPI 1699873372


NPI Information

NPI: 1699873372
Provider Name: PEMISCOT COUNTY MEMORIAL HOSPITAL

Doing Business As: PORTAGEVILLE PRIMARY CARE CENTER

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
314 E MAIN ST
PORTAGEVILLE, MO
ZIP 63873
Phone: (573) 379-3777
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PEMISCOT COUNTY MEMORIAL HOSPITAL is a rural health clinic center in Portageville, MO. PEMISCOT COUNTY MEMORIAL HOSPITAL NPI is 1699873372. The provider is registered as an organization entity type.
The provider Is Doing Business As Portageville Primary Care Center.

The provider's business location address is:

314 E MAIN ST
PORTAGEVILLE, MO
ZIP 63873-616
Phone: (573) 379-3777
Fax: (573) 379-9331

The provider's authorized official is Mark R Davis .
The authorized official title is Ceo and has the following contact phone number (573) 359-3612.

The enumeration date for this NPI number is 9/20/2006 and was last updated on 5/12/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QR1300XClinic/CenterRural HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1263421MEDICARE OSCAR/CERTIFICATIONMISSOURI
2596948109MEDICAIDMISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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