Healthcare Provider Details

I. General information

NPI: 1891914909
Provider Name (Legal Business Name): RIPLEY COUNTY MEMORIAL HOSPITAL SWING BED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 PLUM ST
DONIPHAN MO
63935-1277
US

IV. Provider business mailing address

109 PLUM ST
DONIPHAN MO
63935-1277
US

V. Phone/Fax

Practice location:
  • Phone: 573-996-2141
  • Fax: 573-996-3949
Mailing address:
  • Phone: 573-996-2141
  • Fax: 573-996-3949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number206 46
License Number StateMO

VIII. Authorized Official

Name: MRS. MONYA YORK
Title or Position: CFO
Credential: CFO
Phone: 573-996-2141