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General NPI Number Information
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NPI Number | 1134199417
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Entity Type | Organization
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Legal Business Name | SALEM MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 01/26/2006
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 35629 HIGHWAY 72
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City | SALEM
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State | MO
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Zip | 65560-7217
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Country | US
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Telephone | 573-729-6626
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Fax | 573-729-6502
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Provider Business Mailing Address
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Address Line | PO BOX 774 35629 HWY 72
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City | SALEM
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State | MO
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Zip | 65560-0774
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Country | US
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Telephone | 573-729-6626
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Fax | 573-729-6502
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Authorized Official
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Title or Position | CEO
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Name | MRS. BROOKE BOLLMAN
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Credential |
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Telephone | 573-729-6626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 252-34
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 275N00000X
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Taxonomy Name | Medicare Defined Swing Bed Hospital Unit
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License Number |
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License Number State |
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