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General NPI Number Information
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NPI Number | 1124037130
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Entity Type | Organization
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Legal Business Name | AUDRAIN HEALTH CARE, INC.
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 11/07/2007
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Provider Practice Location Address
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Address Line | 620 E MONROE ST
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City | MEXICO
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State | MO
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Zip | 65265-2919
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Country | US
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Telephone | 573-581-8127
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Fax | 573-582-7053
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Provider Business Mailing Address
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Address Line | P.O. BOX 478
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City | MEXICO
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State | MO
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Zip | 65265
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Country | US
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Telephone | 573-581-8127
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Fax | 573-582-7053
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DAVID A. NEUENDORF
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Credential |
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Telephone | 573-582-8108
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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