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General NPI Number Information
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NPI Number | 1811332935
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Entity Type | Organization
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Legal Business Name | COOPER COUNTY MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 05/02/2013
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Last Update Date | 07/22/2014
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Provider Practice Location Address
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Address Line | 108 MARKET ST
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City | GLASGOW
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State | MO
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Zip | 65254-1053
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Country | US
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Telephone | 660-338-2233
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Fax | 660-338-2817
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Provider Business Mailing Address
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Address Line | 17651 B HWY P O BOX 88
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City | BOONVILLE
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State | MO
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Zip | 65233-2839
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Country | US
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Telephone | 660-882-7461
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Fax | 660-882-6093
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Authorized Official
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Title or Position | CEO
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Name | DANIELLE GEARHART
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Credential |
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Telephone | 660-882-7461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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