Healthcare Provider Details

I. General information

NPI: 1891325072
Provider Name (Legal Business Name): SCOTLAND COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2020
Last Update Date: 01/16/2020
Certification Date: 01/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55682 STATE HIGHWAY 6 STE A
EDINA MO
63537-4268
US

IV. Provider business mailing address

450 E SIGLER AVE
MEMPHIS MO
63555-1726
US

V. Phone/Fax

Practice location:
  • Phone: 660-465-8513
  • Fax: 660-465-2956
Mailing address:
  • Phone: 660-465-8513
  • Fax: 660-465-2956

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: SHERYL SMITH-TEMPLETON
Title or Position: CFO
Credential:
Phone: 660-465-8513