Healthcare Provider Details

I. General information

NPI: 1437251634
Provider Name (Legal Business Name): PEMISCOT COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 WEST 12TH ST
CARUTHERSVILLE MO
63830
US

IV. Provider business mailing address

946 E REED ST P O BOX 489
HAYTI MO
63851-1243
US

V. Phone/Fax

Practice location:
  • Phone: 573-359-1782
  • Fax: 573-333-4665
Mailing address:
  • Phone: 573-359-3612
  • Fax: 573-359-3601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LAUREN TURNAGE
Title or Position: REVENUE CYCLE DIRECTOR
Credential:
Phone: 573-359-3498