Healthcare Provider Details

I. General information

NPI: 1124125539
Provider Name (Legal Business Name): PUTNAM COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 10/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1926 OAK ST
UNIONVILLE MO
63565-1180
US

IV. Provider business mailing address

1926 OAK ST PO BOX 389
UNIONVILLE MO
63565-1180
US

V. Phone/Fax

Practice location:
  • Phone: 660-947-2425
  • Fax: 660-947-7024
Mailing address:
  • Phone: 660-947-2425
  • Fax: 660-947-7024

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: MRS. RHONDA WEBBER
Title or Position: ACCOUNTS PAYABLE
Credential:
Phone: 660-947-2411