MEDICARE: MOBERLY HOSPITAL COMPANY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR1300X	Rural Health Clinic/Center		MO
2	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1316070428
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBERLY HOSPITAL COMPANY LLC

Provider Business Mailing Address
First Line	:	4000 MERIDIAN BLVD
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-6325
Country	:	US
Telephone Number	:	877-892-9813
Fax Number	:	615-465-3007

Provider Business Practice Location Address
First Line	:	1517 UNION AVE STE C
Second Line	:
City	:	MOBERLY
State	:	MO
Zip	:	65270-9471
Country	:	US
Telephone Number	:	660-263-6500
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DEBBIE T BREWER
Credential	:
Telephone Number	:	615-465-7626

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	03/14/2012

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Directions to “MOBERLY HOSPITAL COMPANY LLC ” Practice Location

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