Healthcare Provider Details

I. General information

NPI: 1659675536
Provider Name (Legal Business Name): PIGGOTT COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2011
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 N ASH ST
CAMPBELL MO
63933-1505
US

IV. Provider business mailing address

115 N ASH ST
CAMPBELL MO
63933-1505
US

V. Phone/Fax

Practice location:
  • Phone: 873-246-2882
  • Fax:
Mailing address:
  • Phone: 573-246-2882
  • Fax: 573-246-2122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number196-20
License Number StateMO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier581359908
Identifier TypeMEDICAID
Identifier StateMO
Identifier Issuer
# 2
Identifier196-20
Identifier TypeOTHER
Identifier StateMO
Identifier IssuerMO LICENSE NUMBER

VIII. Authorized Official

Name: MRS. ALICE WHITEHEAD
Title or Position: DIRECTOR
Credential:
Phone: 573-246-2882