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General NPI Number Information
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NPI Number | 1922345800
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Entity Type | Organization
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Legal Business Name | SALEM MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 01/11/2013
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Last Update Date | 04/11/2014
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Provider Practice Location Address
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Address Line | 35629 HIGHWAY 72 BUILDING 1
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City | SALEM
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State | MO
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Zip | 65560-7217
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Country | US
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Telephone | 573-729-5917
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Fax | 573-739-4759
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Provider Business Mailing Address
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Address Line | PO BOX 680
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City | SALEM
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State | MO
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Zip | 65560-0680
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Country | US
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Telephone | 573-729-5917
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Fax | 573-739-4759
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Authorized Official
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Title or Position | CONTROLLER
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Name | MS. REBECCA CUNNINGHAM
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Credential |
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Telephone | 573-729-5917
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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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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2007013987
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License Number State | MO
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