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General NPI Number Information
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NPI Number | 1922094127
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Entity Type | Organization
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Legal Business Name | N & R OF SOUTH HAMPTON, LLC
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Dates
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Enumeration Date | 09/22/2005
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Last Update Date | 12/29/2009
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Provider Practice Location Address
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Address Line | 4700 BRANDON WOODS ST
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City | COLUMBIA
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State | MO
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Zip | 65203-7169
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Country | US
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Telephone | 573-874-3674
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Fax | 573-874-3479
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Provider Business Mailing Address
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Address Line | 4700 BRANDON WOODS ST
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City | COLUMBIA
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State | MO
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Zip | 65203-7169
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Country | US
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Telephone | 573-874-3674
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Fax | 573-874-3479
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Authorized Official
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Title or Position | COO CFO
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Name | MR. THOMAS HUDSPETH
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Credential |
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Telephone | 573-392-0316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 030432
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License Number State | MO
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