Healthcare Provider Details

I. General information

NPI: 1609870195
Provider Name (Legal Business Name): PUTNAM COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2005
Last Update Date: 04/30/2010
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: 660-947-2411
  • Fax: 660-947-3825
Mailing address:
  • Phone: 660-947-2411
  • Fax: 660-947-3825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number222-41
License Number StateMO

VIII. Authorized Official

Name: MRS. KARI CASADY
Title or Position: BUSINESS OFFICE DIRECTOR
Credential:
Phone: 660-947-2411