Healthcare Provider Details

I. General information

NPI: 1447456330
Provider Name (Legal Business Name): MORGAN COUNTY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 W LAFAYETTE ST
VERSAILLES MO
65084-1346
US

IV. Provider business mailing address

104 W LAFAYETTE ST
VERSAILLES MO
65084-1346
US

V. Phone/Fax

Practice location:
  • Phone: 573-378-5438
  • Fax: 573-378-2726
Mailing address:
  • Phone: 573-378-5438
  • Fax: 573-378-2726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: SHAWN BRANTLEY
Title or Position: ASSISTANT ADMINISTRATOR
Credential:
Phone: 573-378-5438