Healthcare Provider Details

I. General information

NPI: 1396785135
Provider Name (Legal Business Name): TEXAS COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 08/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 MAIN STREET
CABOOL MO
65689
US

IV. Provider business mailing address

500 MAIN STREET PO BOX 380
CABOOL MO
65689
US

V. Phone/Fax

Practice location:
  • Phone: 417-962-3015
  • Fax: 417-962-5938
Mailing address:
  • Phone: 417-962-3015
  • Fax: 417-962-5938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. LINDA J. PAMPERIEN
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 417-967-3311