Healthcare Provider Details

I. General information

NPI: 1659632016
Provider Name (Legal Business Name): BOTHWELL REGIONAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2012
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 S HANCOCK AVE
SEDALIA MO
65301-4638
US

IV. Provider business mailing address

PO BOX 801128
KANSAS CITY MO
64180-1128
US

V. Phone/Fax

Practice location:
  • Phone: 660-827-7998
  • Fax: 660-829-8679
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LORI WIGHTMAN
Title or Position: CEO
Credential:
Phone: 660-827-9481