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General NPI Number Information
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NPI Number | 1407989510
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Entity Type | Organization
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Legal Business Name | MOBERLY HOSPITAL COMPANY LLC
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 04/16/2021
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Provider Practice Location Address
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Address Line | 1501 UNION AVE SUITE A & B
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City | MOBERLY
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State | MO
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Zip | 65270-9469
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Country | US
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Telephone | 660-263-9095
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Fax | 660-263-0054
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Provider Business Mailing Address
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Address Line | 1501 UNION AVE SUITE A & B
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City | MOBERLY
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State | MO
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Zip | 65270-9469
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Country | US
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Telephone | 660-263-9095
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Fax | 660-263-0054
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Authorized Official
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Title or Position | DIRECTOR / DELEGATED OFFICIAL
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Name | PAULA M LALOR
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Credential |
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Telephone | 629-215-3953
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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 |
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License Number State |
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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 | MO
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