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NPI Code Detail

MEDICARE: CARROLL COUNTY MEMORIAL HOSPITAL

MEDICARE: CARROLL COUNTY MEMORIAL HOSPITAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
290214014OTHERMOBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1205831013
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARROLL COUNTY MEMORIAL HOSPITAL
Provider Business Mailing Address
First Line : 1502 N JEFFERSON ST
Second Line :
City : CARROLLTON
State : MO
Zip : 64633-1948
Country : US
Telephone Number : 660-542-3301
Fax Number : 660-542-1691
Provider Business Practice Location Address
First Line : 1502 N JEFFERSON ST
Second Line :
City : CARROLLTON
State : MO
Zip : 64633-1948
Country : US
Telephone Number : 660-542-3301
Fax Number : 660-542-1691
Authorized Official
Title or Position : CHIEF REVENUE OFFICER
Name : AMY IRELAND
Credential :
Telephone Number : 660-542-1695
Provider Enumeration Date : 06/17/2005
Last Update Date : 10/29/2021

Similar Medicare Providers

1932105673 — DR. GREGORY WILLIAM HUBBARD D.O.
Practice Location Address:
1502 N JEFFERSON ST
CARROLLTON, MO
64633-1948
Practice Phone: 660-542-1695
Practice Fax: 660-542-1944
1528067113 — CARROLL COUNTY MEMORIAL HOSPITAL
Practice Location Address:
1502 N JEFFERSON ST
CARROLLTON, MO
64633-1948
Practice Phone: 660-542-1695
Practice Fax: 660-542-0363
1346221231 — DR. MARVIN E ROSS DO
Practice Location Address:
1502 N JEFFERSON ST , JEFFERSON MEDICAL GROUP /ATTN: JEAN STEELE
CARROLLTON, MO
64633-1948
Practice Phone: 660-542-9998
Practice Fax: 660-542-9880
1861451015 — GRAZYNA E DYMEK MD
Practice Location Address:
1502 N JEFFERSON ST
CARROLLTON, MO
64633-1948
Practice Phone: 660-542-3965
Practice Fax: 660-542-0336
1861448664 — RICHARD LEE SMITH M.D.
Practice Location Address:
1502 N JEFFERSON ST
CARROLLTON, MO
64633-1948
Practice Phone: 660-542-9998
Practice Fax: 660-542-9880
1942316708 — CARROLL CNTY MEM HOSP PHARMACY INC
Practice Location Address:
1502 N JEFFERSON ST
CARROLLTON, MO
64633-1948
Practice Phone: 660-542-1695
Practice Fax: 660-542-0363

Directions to “CARROLL COUNTY MEMORIAL HOSPITAL ” Practice Location

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