Healthcare Provider Details

I. General information

NPI: 1033109517
Provider Name (Legal Business Name): NEVADA CITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2005
Last Update Date: 06/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 S. ASH
NEVADA MO
64772-3223
US

IV. Provider business mailing address

800 S. ASH
NEVADA MO
64772-3223
US

V. Phone/Fax

Practice location:
  • Phone: 417-667-3355
  • Fax: 417-448-3691
Mailing address:
  • Phone: 417-667-3355
  • Fax: 417-448-3691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number StateMO

VIII. Authorized Official

Name: MR. GREG L SHAW
Title or Position: CFO
Credential:
Phone: 417-448-3618