Healthcare Provider Details

I. General information

NPI: 1831181148
Provider Name (Legal Business Name): COMMUNITY MEMORIAL HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2005
Last Update Date: 10/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 N OHIO ST
APPLETON CITY MO
64724-1609
US

IV. Provider business mailing address

610 N OHIO ST P.O. BOX 6
APPLETON CITY MO
64724-1609
US

V. Phone/Fax

Practice location:
  • Phone: 660-476-2111
  • Fax: 660-476-5591
Mailing address:
  • Phone: 660-476-2111
  • Fax: 660-476-5591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number270-31
License Number StateMO

VIII. Authorized Official

Name: MR. RAYMOND MAGERS
Title or Position: C E O
Credential:
Phone: 660-476-2111