Healthcare Provider Details

I. General information

NPI: 1619084266
Provider Name (Legal Business Name): CEDAR COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 01/27/2021
Certification Date: 01/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1317 S. HIGHWAY 32
EL DORADO SPRINGS MO
64744
US

IV. Provider business mailing address

1317 S. HIGHWAY 32
EL DORADO SPRINGS MO
64744
US

V. Phone/Fax

Practice location:
  • Phone: 417-876-5477
  • Fax: 417-876-5017
Mailing address:
  • Phone: 417-876-5477
  • Fax: 417-876-5017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: JANA C WITT
Title or Position: CEO
Credential:
Phone: 417-876-2511