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General NPI Number Information
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NPI Number | 1669519542
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Entity Type | Organization
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Legal Business Name | STE GENEVIEVE COUNTY MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 01/13/2023
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Provider Practice Location Address
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Address Line | 990 PARK DR
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City | STE GENEVIEVE
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State | MO
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Zip | 63670-1539
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Country | US
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Telephone | 573-883-7724
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Fax | 573-883-4434
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Provider Business Mailing Address
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Address Line | 990 PARK DR
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City | STE GENEVIEVE
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State | MO
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Zip | 63670-1539
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Country | US
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Telephone | 573-883-7724
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Fax |
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Authorized Official
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Title or Position | BUSINESS OFFICE DIRECTOR
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Name | AMANDA WOLK
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Credential |
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Telephone | 573-883-7703
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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 | 184-21
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License Number State | MO
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