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General NPI Number Information
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NPI Number | 1114379153
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Entity Type | Organization
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Legal Business Name | PEMISCOT MEMORIAL HEALTH SYSTEM
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Dates
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Enumeration Date | 07/01/2016
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Last Update Date | 07/01/2016
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Provider Practice Location Address
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Address Line | 946 E REED ST
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City | HAYTI
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State | MO
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Zip | 63851-1243
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Country | US
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Telephone | 573-359-1372
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Fax |
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Provider Business Mailing Address
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Address Line | 946 E REED ST
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City | HAYTI
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State | MO
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Zip | 63851-1243
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Country | US
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Telephone | 573-359-1372
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN ASSISTANT
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Name | LINDA TAI
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Credential | PA-C
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Telephone | 573-359-1372
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NR1301X
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Taxonomy Name | Rural Acute Care Hospital
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License Number | 2016016697
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License Number State | MO
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