Healthcare Provider Details

I. General information

NPI: 1316995939
Provider Name (Legal Business Name): GOLDEN VALLEY MEMORIAL HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 01/02/2020
Certification Date: 01/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S TEBO ST
WINDSOR MO
65360-1161
US

IV. Provider business mailing address

100 S TEBO ST
WINDSOR MO
65360-1161
US

V. Phone/Fax

Practice location:
  • Phone: 660-647-2147
  • Fax:
Mailing address:
  • Phone: 660-647-2147
  • Fax:

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: CRAIG THOMPSON
Title or Position: CEO
Credential:
Phone: 660-885-5511