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General NPI Number Information
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NPI Number | 1003848060
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Entity Type | Organization
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Legal Business Name | LAMAR NO 1 INC
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 02/01/2018
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Provider Practice Location Address
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Address Line | 206 WEST FIRST STREET
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City | LAMAR
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State | MO
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Zip | 64759-1291
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Country | US
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Telephone | 417-682-5718
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1210
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City | SIKESTON
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State | MO
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Zip | 63801-1210
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DONALD B BEDELL
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Credential |
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Telephone | 573-471-1276
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 045991
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License Number State | MO
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