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General NPI Number Information
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NPI Number | 1235166000
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Entity Type | Organization
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Legal Business Name | POPLAR BLUFF REGIONAL MEDICAL CENTER INC
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 12/02/2007
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Provider Practice Location Address
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Address Line | 621 W PINE ST
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City | POPLAR BLUFF
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State | MO
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Zip | 63901-5042
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Country | US
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Telephone | 573-686-5311
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Fax |
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Provider Business Mailing Address
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Address Line | 621 W PINE ST
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City | POPLAR BLUFF
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State | MO
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Zip | 63901-5042
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Country | US
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Telephone | 573-686-5311
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Fax |
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Authorized Official
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Title or Position | SR VP AND GENERAL COUNSEL
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Name | TIMOTHY PARRY
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Credential | ESQ
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Telephone | 239-598-3176
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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 | 7512
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License Number State | MO
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