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General NPI Number Information
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NPI Number | 1568127397
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Entity Type | Organization
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Legal Business Name | CITIZENS MEMORIAL HEALTHCARE
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Dates
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Enumeration Date | 11/06/2021
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 502 SOUTH MILLER ROAD
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City | WILLARD
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State | MO
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Zip | 65781
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Country | US
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Telephone | 417-761-6655
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Fax | 417-761-6646
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Provider Business Mailing Address
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Address Line | 1500 N OAKLAND AVE
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City | BOLIVAR
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State | MO
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Zip | 65613-3011
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Country | US
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Telephone | 417-328-6709
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | RENEE MARIE MEYER
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Credential |
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Telephone | 417-328-6258
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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 |
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