MEDICARE: TEXAS 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
1	251E00000X	Home Health Agency
2	251E00000X	Home Health Agency	101-21	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	26D0446916	OTHER	MO	CLIA
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	101-35HH	OTHER	MO	STATE LICENSE
6	30113	OTHER	MO	BLUE CROSS

General Provider Information

NPI Number	:	1356324727
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXAS COUNTY MEMORIAL HOSPITAL

Provider Business Mailing Address
First Line	:	1333 S SAM HOUSTON BLVD
Second Line	:
City	:	HOUSTON
State	:	MO
Zip	:	65483-2046
Country	:	US
Telephone Number	:	417-967-1240
Fax Number	:	417-967-2360

Provider Business Practice Location Address
First Line	:	1422 S SAM HOUSTON BLVD STE 200
Second Line	:
City	:	HOUSTON
State	:	MO
Zip	:	65483
Country	:	US
Telephone Number	:	417-967-1240
Fax Number	:	417-967-2360

Authorized Official
Title or Position	:	CFO
Name	:	MRS. LINDA J PAMPERIEN
Credential	:
Telephone Number	:	417-967-1255

Provider Enumeration Date	:	11/21/2005
Last Update Date	:	01/15/2020

Similar Medicare Providers

1568463925 — DAVID W DALE D.O.
Practice Location Address:

1340 S SAM HOUSTON BLVD
HOUSTON, MO
65483-2045

Practice Phone: 417-967-3755
Practice Fax: 417-967-2630

1902892847 — GLEN C MARSEY LCSW
Practice Location Address:

1340 S SAM HOUSTON BLVD
HOUSTON, MO
65483-2045

Practice Phone: 417-967-3755
Practice Fax: 417-967-2630

1699763383 — STEVEN CHARLES HUTCHESON PHARMACIST
Practice Location Address:

1330 SOUTH HIGHWAY 63
HOUSTON, MO
65483

Practice Phone: 417-967-4139
Practice Fax: 417-967-4130

1962473975 — DR. HOLLIS TIDMORE MD
Practice Location Address:

1422 S SAM HOUSTON BLVD
HOUSTON, MO
65483-2130

Practice Phone: 417-967-1252
Practice Fax: 417-967-0417

1093780678 — TEXAS COUNTY MEMORIAL HOSPITAL
Practice Location Address:

1422 S SAM HOUSTON BLVD STE 300
HOUSTON, MO
65483-2119

Practice Phone: 417-967-1279
Practice Fax: 417-967-1335

1164483921 — DR. CHRISTOPHER O BALDWIN M.D.
Practice Location Address:

1337 S SAM HOUSTON BLVD
HOUSTON, MO
65483

Practice Phone: 417-967-5639
Practice Fax: 417-967-5667

Directions to “TEXAS COUNTY MEMORIAL HOSPITAL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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