Healthcare Provider Details

I. General information

NPI: 1417820580
Provider Name (Legal Business Name): CITIZENS MEMORIAL HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2025
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 N OAKLAND AVE STE A
BOLIVAR MO
65613-3020
US

IV. Provider business mailing address

1500 N OAKLAND AVE
BOLIVAR MO
65613-3011
US

V. Phone/Fax

Practice location:
  • Phone: 417-328-4875
  • Fax: 417-488-7037
Mailing address:
  • Phone: 417-326-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RENEE MARIE MEYER
Title or Position: CFO
Credential:
Phone: 417-328-6258