MEDICARE: BATES 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	207Q00000X	Family Medicine Physician	29119	MO
2	261QR1300X	Rural Health Clinic/Center	268639	MO
3	261QR1300X	Rural Health Clinic/Center	205-49	MO

General Provider Information

NPI Number	:	1467689398
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BATES COUNTY MEMORIAL HOSPITAL

Provider Business Mailing Address
First Line	:	200 W CHESTNUT ST
Second Line	:
City	:	BUTLER
State	:	MO
Zip	:	64730-1554
Country	:	US
Telephone Number	:	660-200-7137
Fax Number	:	660-200-7015

Provider Business Practice Location Address
First Line	:	200 W CHESTNUT ST
Second Line	:
City	:	BUTLER
State	:	MO
Zip	:	64730-1554
Country	:	US
Telephone Number	:	660-200-7000
Fax Number	:	660-200-7015

Authorized Official
Title or Position	:	CEO
Name	:	MR. GREGORY WEAVER
Credential	:
Telephone Number	:	660-200-7000

Provider Enumeration Date	:	06/18/2009
Last Update Date	:	08/15/2023

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Directions to “BATES COUNTY MEMORIAL HOSPITAL ” Practice Location

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