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General NPI Number Information
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NPI Number | 1033109103
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Entity Type | Organization
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Legal Business Name | GOLDEN VALLEY MEMORIAL HOSPITAL DISTRICT
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Dates
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Enumeration Date | 10/28/2005
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Last Update Date | 02/23/2023
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Provider Practice Location Address
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Address Line | 1703 N 2ND ST.
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City | CLINTON
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State | MO
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Zip | 64735-1192
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Country | US
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Telephone | 660-885-5088
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Fax | 660-885-7756
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Provider Business Mailing Address
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Address Line | 1600 NORTH SECOND ST
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City | CLINTON
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State | MO
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Zip | 64735-1192
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Country | US
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Telephone | 660-885-5088
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Fax | 660-885-7756
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Authorized Official
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Title or Position | CLINIC ADMINISTRATOR
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Name | MEREDITH COOPER
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Credential |
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Telephone | 660-885-8171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 257-33
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 169-25HH
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License Number State | MO
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