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General NPI Number Information
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NPI Number | 1326349861
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Entity Type | Organization
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Legal Business Name | LINCOLN COUNTY MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 11/16/2010
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Last Update Date | 06/22/2011
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Provider Practice Location Address
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Address Line | 1000 E CHERRY ST ATTN: PULMONARY CLINIC 3RD FLOOR
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City | TROY
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State | MO
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Zip | 63379-1513
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Country | US
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Telephone | 636-358-9518
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 E CHERRY ST ATTN: PULMONARY CLINIC 3RD FLOOR
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City | TROY
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State | MO
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Zip | 63379-1513
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Country | US
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Telephone | 636-358-9518
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. PATRICK G. BIRA
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Credential |
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Telephone | 636-528-3326
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 32884
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License Number State | MO
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