Healthcare Provider Details

I. General information

NPI: 1306965280
Provider Name (Legal Business Name): ST. CLAIR COUNTY HOSPITAL DISTRICT #1
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 10/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 GIESLER RD
OSCEOLA MO
64776-6279
US

IV. Provider business mailing address

700 GIESLER RD P. O. BOX 426
OSCEOLA MO
64776-6279
US

V. Phone/Fax

Practice location:
  • Phone: 417-646-8181
  • Fax: 417-646-8379
Mailing address:
  • Phone: 417-646-8181
  • Fax: 417-646-8379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number185019
License Number StateMO

VIII. Authorized Official

Name: ALMA F RODABAUGH
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 417-646-8181