Healthcare Provider Details

I. General information

NPI: 1821397712
Provider Name (Legal Business Name): LINCOLN COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2011
Last Update Date: 09/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 E CHERRY ST
TROY MO
63379-1520
US

IV. Provider business mailing address

1175 E CHERRY ST
TROY MO
63379-1520
US

V. Phone/Fax

Practice location:
  • Phone: 636-528-8686
  • Fax: 636-528-3332
Mailing address:
  • Phone: 636-528-8686
  • Fax: 636-528-3332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. PATRICK G. BIRA
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 636-528-3226