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NPI Code Detail

MEDICARE: POPLAR BLUFF REGIONAL MEDICAL CENTER LLC

MEDICARE: POPLAR BLUFF REGIONAL MEDICAL CENTER 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
1261QR1300XRural Health Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801839147
Entity Type Code : Organization
Provider Name (Legal Business Name) : POPLAR BLUFF REGIONAL MEDICAL CENTER LLC
Provider Business Mailing Address
First Line : 806 N DOUGLASS ST
Second Line :
City : MALDEN
State : MO
Zip : 63863-1512
Country : US
Telephone Number : 573-276-3873
Fax Number : 573-276-2625
Provider Business Practice Location Address
First Line : 806 N DOUGLASS ST
Second Line :
City : MALDEN
State : MO
Zip : 63863-1512
Country : US
Telephone Number : 573-276-3873
Fax Number :
Authorized Official
Title or Position : DIRECTOR/DELEGATED OFFICIAL
Name : PAULA LALOR
Credential :
Telephone Number : 629-215-3953
Provider Enumeration Date : 06/14/2006
Last Update Date : 04/20/2021

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Directions to “POPLAR BLUFF REGIONAL MEDICAL CENTER LLC ” Practice Location

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