Healthcare Provider Details

I. General information

NPI: 1528062569
Provider Name (Legal Business Name): HARRISON COUNTY COMMUNITY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2005
Last Update Date: 03/24/2021
Certification Date: 03/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 MILLER ST
BETHANY MO
64424-2701
US

IV. Provider business mailing address

2600 MILLER ST
BETHANY MO
64424-2701
US

V. Phone/Fax

Practice location:
  • Phone: 660-425-2211
  • Fax: 660-425-2366
Mailing address:
  • Phone: 660-425-2211
  • Fax: 660-425-2366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number372-16
License Number StateMO

VIII. Authorized Official

Name: CHRISTINA GILLESPIE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 660-425-2211