Healthcare Provider Details

I. General information

NPI: 1194731539
Provider Name (Legal Business Name): LINCOLN COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 10/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 E CHERRY ST
TROY MO
63379-1429
US

IV. Provider business mailing address

900 E CHERRY ST
TROY MO
63379-1429
US

V. Phone/Fax

Practice location:
  • Phone: 636-528-8585
  • Fax: 636-528-8430
Mailing address:
  • Phone: 636-528-8585
  • Fax: 636-528-8430

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: MR. PATRICK G. BIRA
Title or Position: CEO
Credential:
Phone: 636-528-8551