Healthcare Provider Details

I. General information

NPI: 1629276209
Provider Name (Legal Business Name): SCOTLAND COUNTY MEMORIAL HOSPITAL DBA LANCASTER MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2007
Last Update Date: 10/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HWY 63 N
LANCASTER MO
63548
US

IV. Provider business mailing address

RR 1 BOX 54
MEMPHIS MO
63555-9788
US

V. Phone/Fax

Practice location:
  • Phone: 660-457-3655
  • Fax: 660-457-3656
Mailing address:
  • Phone: 660-465-2828
  • Fax: 660-465-2820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARCIA R DIAL
Title or Position: CEO
Credential:
Phone: 660-465-8511