Healthcare Provider Details
I. General information
NPI: 1811062375
Provider Name (Legal Business Name): HERMANN AREA HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/21/2006
Last Update Date: 04/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
504 N STURGEON ST
MONTGOMERY CITY MO
63361-1829
US
IV. Provider business mailing address
PO BOX 19
HERMANN MO
65041-0019
US
V. Phone/Fax
- Phone: 573-564-2990
- Fax: 573-564-2963
- Phone: 573-486-1193
- Fax: 573-486-0910
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR1300X |
| Taxonomy | Rural Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAN
MCKINNEY
Title or Position: ADMINISTRATOR
Credential:
Phone: 573-486-2191