Healthcare Provider Details

I. General information

NPI: 1083749188
Provider Name (Legal Business Name): HERMANN AREA HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 WEST 18TH
HERMANN MO
65041
US

IV. Provider business mailing address

PO BOX 19
HERMANN MO
65041-0019
US

V. Phone/Fax

Practice location:
  • Phone: 573-486-2191
  • Fax: 573-486-3743
Mailing address:
  • Phone: 573-486-1193
  • Fax: 573-486-0910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ELLEN SCHAUMBERG
Title or Position: CBO DIRECTOR
Credential:
Phone: 573-486-1193