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General NPI Number Information
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NPI Number | 1396741302
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Entity Type | Organization
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Legal Business Name | COMMUNITY HOSPITAL ASSOCIATION
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Dates
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Enumeration Date | 06/23/2005
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Last Update Date | 12/18/2020
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Provider Practice Location Address
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Address Line | 100 E CASS ST
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City | ROCK PORT
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State | MO
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Zip | 64482-1528
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Country | US
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Telephone | 660-744-5361
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Fax | 660-744-2247
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Provider Business Mailing Address
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Address Line | 100 E CASS STREET
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City | ROCK PORT
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State | MO
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Zip | 64482-1528
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Country | US
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Telephone | 660-744-5361
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Fax | 660-744-2247
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Authorized Official
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Title or Position | CFO
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Name | JON P DAVIS
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Credential |
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Telephone | 660-686-2320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | MO
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Taxonomy #2
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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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