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General NPI Number Information
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NPI Number | 1972584340
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Entity Type | Organization
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Legal Business Name | AUDRAIN COUNTY HEALTH CENTER
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Dates
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Enumeration Date | 11/10/2005
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Last Update Date | 12/05/2013
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Provider Practice Location Address
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Address Line | 1130 S ELMWOOD
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City | MEXICO
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State | MO
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Zip | 65265-0957
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Country | US
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Telephone | 573-581-6060
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Fax | 573-581-6652
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Provider Business Mailing Address
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Address Line | 1130 S ELMWOOD P.O. BOX 957
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City | MEXICO
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State | MO
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Zip | 65265-0957
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Country | US
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Telephone | 573-581-6060
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Fax | 573-581-6652
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Authorized Official
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Title or Position | BOARD CHAIRPERSON
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Name | DR. PATRICIA BURKE
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Credential | M. D.
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Telephone | 573-581-1332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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