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General NPI Number Information
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NPI Number | 1366511537
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Entity Type | Organization
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Legal Business Name | ST. JOHN'S REGIONAL HEALTH CENTER
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 11/02/2009
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Provider Practice Location Address
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Address Line | 1602 ELLIOTT STREET SUITE E
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City | AURORA
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State | MO
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Zip | 65605-2133
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Country | US
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Telephone | 417-678-2158
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Fax | 417-678-0414
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Provider Business Mailing Address
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Address Line | 1570 W BATTLEFIELD ST SUITE 110
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City | SPRINGFIELD
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State | MO
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Zip | 65807-4106
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Country | US
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Telephone | 417-820-7492
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Fax | 417-820-5551
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Authorized Official
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Title or Position | GENERAL COUNSEL
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Name | MICHAEL MERRIGAN
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Credential |
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Telephone | 417-820-2258
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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 | 159-22
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 15925HH
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License Number State | MO
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