Healthcare Provider Details

I. General information

NPI: 1427480995
Provider Name (Legal Business Name): CITIZENS MEMORIAL HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2013
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 S ASH ST
BUFFALO MO
65622-8705
US

IV. Provider business mailing address

1500 N OAKLAND AVE
BOLIVAR MO
65613-3011
US

V. Phone/Fax

Practice location:
  • Phone: 417-345-2321
  • Fax: 417-345-8837
Mailing address:
  • Phone: 417-328-6258
  • Fax: 417-328-6242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

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