Healthcare Provider Details

I. General information

NPI: 1841307428
Provider Name (Legal Business Name): FREEMAN NEOSHO HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2006
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 W 32ND ST
JOPLIN MO
64804-3503
US

V. Phone/Fax

Practice location:
  • Phone: 417-451-1234
  • Fax: 417-347-0702
Mailing address:
  • Phone: 417-347-1111
  • Fax: 417-347-0702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State

VIII. Authorized Official

Name: STEVEN W GRADDY
Title or Position: CFO
Credential:
Phone: 417-347-6678