{
"Npi": {
"NPI": "1992807390",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PEMISCOT COUNTY MEMORIAL HOSPITAL",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 442",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HAYTI",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "63851-0442",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "573-359-3659",
"MailingAddressFaxNumber": "573-359-3608",
"FirstLinePracticeLocationAddress": "1231 1ST ST STE 5",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "KENNETT",
"PracticeLocationAddressStateName": "MO",
"PracticeLocationAddressPostalCode": "63857-2521",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "573-888-8828",
"PracticeLocationAddressFaxNumber": "573-888-8830",
"EnumerationDate": "09/05/2006",
"LastUpdateDate": "08/07/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TURNAGE",
"AuthorizedOfficialFirstName": "LAUREN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "REVENUE CYCLE DIRECTOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "573-359-3498",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QR1300X",
"TaxonomyName": "Rural Health Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}