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General NPI Number Information
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NPI Number | 1346533569
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Entity Type | Organization
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Legal Business Name | MCCUNE BROOKS HOSPITAL
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Dates
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Enumeration Date | 05/20/2011
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Last Update Date | 05/20/2011
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Provider Practice Location Address
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Address Line | 1515 HAZEL ST SUITE 204
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City | CARTHAGE
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State | MO
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Zip | 64836-2850
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Country | US
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Telephone | 417-237-0983
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Fax | 417-237-0997
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Provider Business Mailing Address
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Address Line | 1515 HAZEL ST SUITE 204
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City | CARTHAGE
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State | MO
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Zip | 64836-2850
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Country | US
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Telephone | 417-237-0983
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Fax | 417-237-0997
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Authorized Official
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Title or Position | CEO
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Name | MR. ROBERT Y COPELAND
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Credential |
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Telephone | 417-358-8121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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