Healthcare Provider Details

I. General information

NPI: 1689782872
Provider Name (Legal Business Name): FREEMAN NEOSHO HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 10/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 W HICKORY ST
NEOSHO MO
64850-1705
US

IV. Provider business mailing address

1102 WEST 32ND STREET
JOPLIN MO
64804
US

V. Phone/Fax

Practice location:
  • Phone: 417-347-1234
  • Fax: 417-347-0702
Mailing address:
  • Phone: 417-347-1111
  • Fax: 417-347-0702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: MR. STEVE W GRADDY
Title or Position: CFO
Credential:
Phone: 417-347-6678