Healthcare Provider Details

I. General information

NPI: 1285957001
Provider Name (Legal Business Name): TEXAS COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2010
Last Update Date: 09/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1905 WEST 19TH STREET
MOUNTAIN GROVE MO
65711
US

IV. Provider business mailing address

1905 WEST 19TH STREET
MOUNTAIN GROVE MO
65711
US

V. Phone/Fax

Practice location:
  • Phone: 417-926-1770
  • Fax: 417-926-1785
Mailing address:
  • Phone: 417-926-1770
  • Fax: 417-926-1785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. LINDA J. PAMPERIEN
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 417-967-3311